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Sample records for carcinoides gastrointestinales tratamiento

  1. Carcinoid Cancer Foundation

    MedlinePlus

    ... Pay? Resources for Carcinoid and NET Cancer Insurance Appeals Mobile App A Review of Carcinoid Cancer UN ... Pay? Resources for Carcinoid and NET Cancer Insurance Appeals Mobile App A Review of Carcinoid Cancer UN ...

  2. Lung Carcinoid Tumor: Surgery

    MedlinePlus

    ... for lung carcinoid tumor symptoms Surgery to treat lung carcinoid tumors Surgery is the main treatment for ... often be cured by surgery alone. Types of lung surgery Different operations can be used to treat ( ...

  3. Tumores carcinoides gastrointestinales—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del tumor carcinoide gastrointestinal, así como referencias a estudios clínicos y otros temas relacionados.

  4. Pazopanib Hydrochloride in Treating Patients With Progressive Carcinoid Tumors

    ClinicalTrials.gov

    2016-11-04

    Atypical Carcinoid Tumor; Foregut Carcinoid Tumor; Hindgut Carcinoid Tumor; Lung Carcinoid Tumor; Metastatic Carcinoid Tumor; Metastatic Digestive System Neuroendocrine Tumor G1; Midgut Carcinoid Tumor; Recurrent Digestive System Neuroendocrine Tumor G1; Regional Digestive System Neuroendocrine Tumor G1

  5. Giant thymic carcinoid.

    PubMed

    John, L C; Hornick, P; Lang, S; Wallis, J; Edmondson, S J

    1991-05-01

    Thymic carcinoid is a rare tumour. It may present with ectopic endocrine secretion or with symptoms of compression as a result of its size. A case is reported which presented with symptoms of compression where the size of the tumour was uniquely large such as to warrant the term giant thymic carcinoid. The typical histological features are described, together with its possible origin and its likely prognosis.

  6. Stages of Gastrointestinal Carcinoid Tumors

    MedlinePlus

    ... symptoms of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part ... Treatment of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part ...

  7. Can Gastrointestinal Carcinoid Tumors Be Found Early?

    MedlinePlus

    ... problems. Carcinoid tumors often are found incidentally (by accident). These tumors aren’t causing any symptoms but ... Carcinoid Tumors? Causes, Risk Factors, and Prevention Early Detection, Diagnosis, and Staging Treating Gastrointestinal Carcinoid Tumors Talking ...

  8. Carcinoid syndrome from gastrointestinal carcinoids without liver metastasis.

    PubMed

    Feldman, J M; Jones, R S

    1982-07-01

    Although patients with bronchial and ovarian carcinoid tumors can develop the carcinoid syndrome (diarrhea and/or flushing) in the absence of hepatic metastasis, it is believed that development of the carcinoid syndrome in patients with carcinoid tumors of gastrointestinal origin occurs only after the patient has hepatic metastasis. This is explained by hepatic inactivation of most of the serotonin in the portal circulation or by the fact that hepatic metastases are larger than the primary tumor in the gastrointestinal tract. Three patients with ileal and jejunal carcinoid tumors who developed the carcinoid syndrome without obvious hepatic metastasis are described. Two of the patients had intra-abdominal, but extrahepatic, metastasis that probably drained directly into the systemic circulation. The third patient had an ileal carcinoid with clinical involvement limited to adjacent mesenteric lymph nodes. Following resection of her tumor, her urinary 5-HIAA excretion and platelet serotonin level returned to normal, and her attacks of carcinoid flushing virtually ceased. She has occasional spells of "blushing" that are thought to be benign; however, further close follow-up study will be needed to be certain that she is free of disease. It is suggested that each patient with the carcinoid syndrome be evaluated with CT and technetium-99 pertechnetate liver scans. If there is no liver involvement detected with these studies, one should consider hepatic arteriogram or laparotomy to determine if the patient's tumor might be totally resectable. PMID:7092350

  9. Treatment of Lung Carcinoid by Type and Extent of Disease

    MedlinePlus

    ... your doctor about lung carcinoid tumors? Treatment of lung carcinoid, by type and extent of disease The ... those that can’t be removed completely Resectable lung carcinoid tumors Resectable carcinoid tumors haven’t spread ...

  10. How Are Lung Carcinoid Tumors Diagnosed?

    MedlinePlus

    ... Research Get Involved Find Local ACS Learn About Cancer » Lung Carcinoid Tumor » Detailed Guide » How are lung carcinoid tumors diagnosed? Share this Page Close Push escape to close share window. Print ...

  11. Treatment Options for Gastrointestinal Carcinoid Tumors

    MedlinePlus

    ... symptoms of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part ... Treatment of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part ...

  12. General Information about Gastrointestinal Carcinoid Tumors

    MedlinePlus

    ... symptoms of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part ... Treatment of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part ...

  13. Treatment Option Overview (Gastrointestinal Carcinoid Tumors)

    MedlinePlus

    ... symptoms of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part ... Treatment of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part ...

  14. What's New in Gastrointestinal Carcinoid Tumors Research and Treatment?

    MedlinePlus

    ... Topic Additional resources for gastrointestinal carcinoid tumors What’s new in gastrointestinal carcinoid tumor research and treatment? There ... for the causes of , ways to prevent , and new approaches to diagnose and treat GI carcinoid tumors. ...

  15. [Atypical case of bronchial carcinoid].

    PubMed

    Andrzejak, R; Mydłowski, R; Krajewski, E; Orłowski, T; Bochnia, M

    1997-01-01

    This article illustrates problems in diagnosis and treatment of an atypical form of bronchial carcinoid. We described the case of a 49-year old man, exposed to granite dust and noise for 25 years who had suffered from frequent bronchitis inflammations and pneumonias for 5 years prior to the diagnosis. He was admitted to our clinic because of supposed occupational nature of hearing deficiency. Although a pneumoconiosis was excluded before the admission, we found clinical and X-ray features of the right lung emphysema with medium restrictive ventilation disturbances. Bronchoscopy was performed because of "bright" right lung and ventilation disturbances and it showed presence of the carcinoid. Unusual in this case were tiny anamnestical findings (mild dyspnea attacks after physical effort or nervousness) plus increasing frequency of reported from the childhood bronchitis and pneumonias and uncharacteristic "bright" right lung in X-ray. Therapeutical difficulties resulted from atypical histological form of the tumor, its diameter, polypous-infiltrative character, and inconvenient localization. In spite of late diagnosis of carcinoid and significant acceleration of respiratory decompensation symptoms after the diagnosis the attempt of surgical therapy was appropriate but unsuccessful. After the operation the patient was suffering long lasting lowering of arterial pressure (what was corrected with catecholamine infusions) probably as a result of serotonin secretion. However it was not established because of technical reasons.

  16. Carcinoid heart disease: Diagnosis and management.

    PubMed

    Luis, Sushil A; Pellikka, Patricia A

    2016-01-01

    Hedinger syndrome refers to carcinoid valvular heart disease. The disease is believed to be triggered by vasoactive substances that result in valvular fibrosis. It classically occurs in patients with metastatic carcinoid and preferentially involves the right sided cardiac valves. Affected valves become thickened and retracted, exhibiting regurgitation and sometimes, stenosis. Echocardiography is recommended in patients with carcinoid syndrome and a follow up study is advisable in those who develop a murmur or other symptoms or signs of valvular heart disease. For appropriately selected patients, valve replacement surgery appears to improve outcomes.

  17. Gastric carcinoids: Between underestimation and overtreatment

    PubMed Central

    Massironi, Sara; Sciola, Valentina; Spampatti, Matilde Pia; Peracchi, Maddalena; Conte, Dario

    2009-01-01

    Gastric carcinoids (GCs), which originate from gastric enterochromaffin-like (ECL) mucosal cells and account for 2.4% of all carcinoids, are found increasingly in the course of upper gastrointestinal tract endoscopy. Current nosography includes those occurring in chronic conditions with hypergastrinemia, as the type 1 associated with chronic atrophic gastritis, and the type 2 associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type 3, which is unrelated to hypergastrinemia and is frequently malignant, with distant metastases. The optimal clinical approach to GCs remains to be elucidated, depending upon type, size and number of carcinoids. While there is agreement concerning the treatment of type 3 carcinoids, for types 1 and 2, current possibilities include simple surveillance, endoscopic polypectomy, surgical excision, associated or not with surgical antrectomy, or total gastrectomy. Moreover, the recent introduction of somatostatin analogues represents a therapeutic option of possibly outstanding relevance. PMID:19437556

  18. [Appendiceal carcinoid tumors. Evaluation of long-term outcomes in a tertiary level].

    PubMed

    Suárez-Grau, Juan Manuel; García-Ruiz, Salud; Rubio-Chaves, Carolina; Bustos-Jiménez, Manuel; Docobo-Durantez, Fernando; Padillo-Ruiz, Francisco Javier

    2014-01-01

    Antecedentes: los tumores apendiculares se encuentran en cerca de 1% de las apendicectomías y representan 0.5% de las neoplasias intestinales. El tipo de tumor más frecuente es el carcinoide apendicular, que casi siempre es un hallazgo durante la apendicectomía por otro motivo. Su pronóstico es excelente y la supervivencia es mayor de 95% a cinco años de la intervención. Objetivo: reportar una serie de casos y analizar la supervivencia media a cinco años posteriores a la identificación el tumor. Material y métodos: análisis retrospectivo (1990-2010) de pacientes con tumor carcinoide apendicular intervenidos en el servicio de Cirugía General y del Aparato Digestivo del Hospital Universitario Virgen del Rocío, Sevilla, España. Se analizaron: la supervivencia a cinco años, la necesidad de tratamiento complementario y las pruebas para seguimiento en la consulta. Resultados: se encontraron 42 pacientes intervenidos por tener un tumor carcinoide apendicular. En 38 pacientes la operación fue de urgencia, la mayoría por sospecha de apendicitis aguda, sin que en ninguno se hubiera establecido el diagnóstico de tumor carcinoide antes de la operación. El síntoma predominante al ingreso fue el dolor abdominal. El tratamiento quirúrgico fue: apendicectomía en 34 pacientes (12 por laparoscopia), en el intraoperatorio siete pacientes requirieron resecciones colónicas mayores debido a la afectación del colon; sólo uno requirió la reintervención para completar la hemicolectomía derecha. Al momento del diagnóstico dos pacientes tenían enfermedad diseminada (metástasis hepáticas). La supervivencia a cinco años fue superior a 95%, sin recidivas o tratamiento posterior de la enfermedad. Conclusiones: el tumor carcinoide apendicular difícilmente se diagnostica antes del procedimiento quirúrgico. La apendicectomía suele ser suficiente aunque en algunos pacientes las resecciones colónicas son necesarias por diseminación. La supervivencia a 5 años es

  19. What Are the Key Statistics for Lung Carcinoid Tumors?

    MedlinePlus

    ... Research Get Involved Find Local ACS Learn About Cancer » Lung Carcinoid Tumor » Detailed Guide » What are the key statistics about lung carcinoid tumors? Share this Page Close Push escape to close share window. Print ...

  20. What Are the Risk Factors for Lung Carcinoid Tumors?

    MedlinePlus

    ... Research Get Involved Find Local ACS Learn About Cancer » Lung Carcinoid Tumor » Detailed Guide » What are the risk factors for lung carcinoid tumors? Share this Page Close Push escape to close share window. Print ...

  1. What Should You Ask Your Doctor about Lung Carcinoid Tumors?

    MedlinePlus

    ... Research Get Involved Find Local ACS Learn About Cancer » Lung Carcinoid Tumor » Detailed Guide » What should you ask your doctor about lung carcinoid tumors? Share this Page Close Push escape to close share window. Print ...

  2. What Happens after Treatment for Lung Carcinoid Tumors?

    MedlinePlus

    ... Research Get Involved Find Local ACS Learn About Cancer » Lung Carcinoid Tumor » Detailed Guide » What happens after treatment for lung carcinoid tumors? Share this Page Close Push escape to close share window. Print ...

  3. What's New in Lung Carcinoid Tumor Research and Treatment?

    MedlinePlus

    ... Topic Additional resources for lung carcinoid tumors What’s new in lung carcinoid tumor research and treatment? Many ... controlling when our cells grow and divide into new cells. Certain genes that cause cells to grow, ...

  4. [Ileal carcinoid tumors. Value of small intestine transit].

    PubMed

    Mugel-Riwer, B; Bersani, D; Mugel, J L

    1983-05-01

    The authors describe two personnel observations of ileal carcinoid tumors, demonstrated by double contrast small bowel examination. Confirmation came from operation and histology. Small bowel examination can demonstrate limited carcinoid tumors giving no angiographic traduction.

  5. Complicaciones gastrointestinales (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca del estreñimiento, impacción, obstrucción intestinal y diarrea como complicaciones del cáncer o su tratamiento. Se discute el manejo de estos problemas.

  6. Carcinoid tumor of the middle ear.

    PubMed

    Nikanne, Elina; Kantola, Olli; Parviainen, Tapani

    2004-08-01

    Although carcinoid tumors are labeled as neuroendocrine tumors they can also originate in tissue lacking neuroendocrine cells, such as that in the middle ear. Symptoms of a carcinoid tumor in the middle ear are common ear symptoms such as fullness, pain and hearing loss. Carcinoid tumors have also been considered to be slow-growing. Both these aspects can easily lead to a relatively late diagnosis of carcinoid tumor of the middle ear. The diagnosis is made histologically, and the tumor is primarily treated surgically. In the follow-up of patients, octreotide scanning has proved to be a sensitive method in cases of both recurrence and metastasis. Our patient was a 34-year-old, otherwise healthy female with left-sided acute otitis media and facial palsy in her left ear. She had also suffered from the same symptoms 4 years earlier. She was treated with an operation, and the histologic diagnosis was a carcinoid tumor. In the follow-up of the patient we used octreotide scanning.

  7. PHACES syndrome associated with carcinoid endobronchial tumor.

    PubMed

    Mama, Nadia; H'mida, Dorra; Lahmar, Imen; Yacoubi, Mohamed Tahar; Tlili-Graiess, Kalthoum

    2014-05-01

    PHACES syndrome consists of the constellation of manifestations including posterior fossa anomalies of the brain (most commonly Dandy-Walker malformations), hemangiomas of the face and scalp, arterial abnormalities, cardiac defects, eye anomalies and sternal defects. We present a case with a possible PHACES syndrome including sternal cleft and supraumbilical raphé, precordial skin tag, persistent left superior vena cava and subtle narrowing of the aorta with an endobronchial carcinoid tumor. All these anomalies were discovered on chest multi-detector CT. This is a unique case of PHACES syndrome associated with carcinoid tumor. Review of the literature revealed 3 cases of PHACES syndrome with glial tumor. The authors tried to find the relationship between PHACES syndrome and carcinoid tumors or gliomas, which all derive from the neural crest cells.

  8. Primary renal carcinoid tumor: A radiologic review

    PubMed Central

    Lamb, Leslie; Shaban, Wael

    2015-01-01

    Carcinoid tumor is the classic famous anonym of neuroendocrine neoplasms. Primary renal carcinoid tumors are extremely rare, first described by Resnick and colleagues in 1966, with fewer than a total of 100 cases reported in the literature. Thus, given the paucity of cases, the clinical and histological behavior is not well understood, impairing the ability to predict prognosis. Computed tomography and (occasionally) octreotide studies are used in the diagnosis and followup of these rare entites. A review of 85 cases in the literature shows that no distinctive imaging features differentiate them from other primary renal masses. The lesions tend to demonstrate a hypodense appearance and do not usually enhance in the arterial phases, but can occasionally calcify. Octreotide scans do not seem to help in the diagnosis; however, they are more commonly used in the postoperative followup. In addition, we report a new case of primary renal carcinoid in a horseshoe kidney. PMID:27186242

  9. [Ultrasonographic study of rectal carcinoid tumors].

    PubMed

    Nomura, M; Fujita, N; Matsunaga, A; Ando, M; Tominaga, G; Noda, Y; Kobayashi, G; Kimura, K; Yuki, T; Ishida, K; Yago, A; Mochizuki, F; Chonan, A

    1996-11-01

    To compare intraluminal ultrasonographic (ILUS) findings with histological findings of rectal carcinoid tumors, 35 patients with rectal carcinoid tumors were reviewed. The results were as follows: 1) The rectal wall was visualized as a seven- or nine-layer structure by means of ILUS in 81% of the patients. 2) The possibility that the thin hyperechoic third layer above the tumor on ILUS corresponds to the muscularis mucosae and fibrointerstitium above the tumor histologically. 3) In cases with relatively high internal echoes, the amount of fibrointerstitium exceeded that of tumor cells histologically. 4) In cases with nonuniform internal echo patterns, tumor cells were separated by thick fibrointerstitium forming nodular nests.

  10. Pneumothorax as atypical presentation of bronchial carcinoid.

    PubMed

    Madrid-Carbajal, Claudia J; García-Clemente, Marta M; Gutiérrez-Rodríguez, Margarita; Pando-Sandoval, Ana; Alvarez-Santín, Laura; Casan-Clarà, Pere

    2013-12-01

    We present a case of pneumothorax associated with an endobronchial carcinoid tumor in a 18-year-old man with dyspnea and chest pain. Additional tests were done, identifying in the chest roentgenogram a complete left pneumothorax with persistent leak, which was confirmed by computed tomography of the chest, and also finding an endobronchial lesion that limited the complete reexpansion of the left lung. Surgical excision was performed, and the lesion was identified as a typical bronchial carcinoid, with satisfactory outcome after the intervention. PMID:24296189

  11. Pneumothorax as atypical presentation of bronchial carcinoid.

    PubMed

    Madrid-Carbajal, Claudia J; García-Clemente, Marta M; Gutiérrez-Rodríguez, Margarita; Pando-Sandoval, Ana; Alvarez-Santín, Laura; Casan-Clarà, Pere

    2013-12-01

    We present a case of pneumothorax associated with an endobronchial carcinoid tumor in a 18-year-old man with dyspnea and chest pain. Additional tests were done, identifying in the chest roentgenogram a complete left pneumothorax with persistent leak, which was confirmed by computed tomography of the chest, and also finding an endobronchial lesion that limited the complete reexpansion of the left lung. Surgical excision was performed, and the lesion was identified as a typical bronchial carcinoid, with satisfactory outcome after the intervention.

  12. Atypical Bronchial Carcinoid Masquerading as Bronchial Asthma.

    PubMed

    Rajendran, V; Iqbal; Kumar, Vinod

    2015-11-01

    A case study of 35-year-old woman with persistent breathlessness and wheezing that had been unsuccessfully treated with inhaled beta 2-agonists and steroids for about two years. Patient developed dry cough and haemoptysis, so investigated further. Spirometry demonstrated a restrictive pattern. Chest CT demonstrated well defined hyperdense lesion in right middle lobe. Biopsy taken from the mass during bronchoscopy demonstrated the picture of atypical bronchial carcinoid. In this case, due to the lack of awareness, diagnosis of carcinoid was delayed by two years. PMID:27608788

  13. [Atypical carcinoid of larynx: a case report].

    PubMed

    Gu, Wenjing; Wang, Xin; Shi, Jinfeng

    2015-09-01

    An 70-year-old male come for swallowing pain 5 years, turning worse 10 months. Laryngoscopy showed a tumor with rough surface at the laryngeal surface of epiglottic. Outpatient pathology: poorly differentiated carcinoma of the larynx. CT: the root of epiglottic is slightly thickened. He accepted the partial laryngectomy, tracheotomy, bilateral functional neck dissection. Pathology: atypical carcinoid of larynx.

  14. [A case of recurrent cough in bronchial carcinoid].

    PubMed

    Strano, M; Funis, M; Frediani, S; Duvina, P L

    1999-01-01

    The carcinoid tumors of the bronchial are extremely uncommon, with an incidence of 5% of all pulmonary neoplasms. The carcinoid is the more frequent tumor of the lung in paediatric age. The symptoms most often reported were cough, recurring infection, chest pain, hemoptysis, fever, dyspnea, mild dyspnea attacks after physical effort or nervousness. The carcinoid syndrome is uncommon. Neuroendocrine tumors of the lung embrace a spectrum from low-grade typical carcinoid, intermediate-grade atypical carcinoid, and high-grade categories of large cell neuroendocrine carcinoma and small cell carcinoma. Low grade neoplasms may metastasize to adjacent nodes. Atypical carcinoids are considered low grade malignancies. Most malignant end of neuroendocrine neoplasm group is small cell carcinoma. Typical carcinoids carry an excellent prognosis and should be offered conservative lung resection, whilst atypical carcinoids which behave aggressively should be treated by radical lung resection. The authors report a case of the young patients with bronchial typical carcinoid tumor who had suffered from cough and mild dyspnea attacks after physical effort or nervousness in the last year. PMID:10570790

  15. Primary Hepatic Carcinoid Tumor with Poor Outcome.

    PubMed

    Parkash, Om; Ayub, Adil; Naeem, Buria; Najam, Sehrish; Ahmed, Zubair; Jafri, Wasim; Hamid, Saeed

    2016-03-01

    Primary Hepatic Carcinoid Tumor (PHCT) represents an extremely rare clinical entity with only a few cases reported to date. These tumors are rarely associated with metastasis and surgical resection is usually curative. Herein, we report two cases of PHCT associated with poor outcomes due to late diagnosis. Both cases presented late with non-specific symptoms. One patient presented after a 2-week history of symptoms and the second case had a longstanding two years symptomatic interval during which he remained undiagnosed and not properly worked up. Both these cases were diagnosed with hepatic carcinoid tumor, which originates from neuroendocrine cells. Case 1 opted for palliative care and expired in one month’s time. Surgical resection was advised to the second case, but he left against medical advice. PMID:26975959

  16. Primary Hepatic Carcinoid Tumor with Poor Outcome.

    PubMed

    Parkash, Om; Ayub, Adil; Naeem, Buria; Najam, Sehrish; Ahmed, Zubair; Jafri, Wasim; Hamid, Saeed

    2016-03-01

    Primary Hepatic Carcinoid Tumor (PHCT) represents an extremely rare clinical entity with only a few cases reported to date. These tumors are rarely associated with metastasis and surgical resection is usually curative. Herein, we report two cases of PHCT associated with poor outcomes due to late diagnosis. Both cases presented late with non-specific symptoms. One patient presented after a 2-week history of symptoms and the second case had a longstanding two years symptomatic interval during which he remained undiagnosed and not properly worked up. Both these cases were diagnosed with hepatic carcinoid tumor, which originates from neuroendocrine cells. Case 1 opted for palliative care and expired in one month’s time. Surgical resection was advised to the second case, but he left against medical advice.

  17. [Renal neuroendocrine tumor (carcinoid) : a case report].

    PubMed

    Inagaki, Yusuke; Fujita, Kazutoshi; Nakai, Yasutomo; Takayama, Hitoshi; Tsujimura, Akira; Nonomura, Norio

    2013-11-01

    A 32-year-old man was referred to our hospital for treatment of left renal cystic tumor, which was detected by computed tomographic (CT) scan 3 years ago. CT scan showed a multilocular cyst (5 cm in diameter) with a solid tumor in the left kidney which was enhanced with contrast. There was no evidence of extrarenal invasion or distant metastasis. We performed retroperitoneal laparoscopic radical nephrectomy. Pathological examinations revealed a cellular arrangement specific to carcinoid tumor and positive for CD56 (NCAM) and neuron-specific enolase. The cell proliferation rate was estimated to be under 2% with Ki67 staining. The pathological diagnosis was renal neuroendocrine tumor (carcinoid). At the 9-month follow up, he had no evidence of local recurrence or metastasis.

  18. Carcinoid Tumor in Accidental, Asymptomatic Meckel's Diverticulum.

    PubMed

    Baranyai, Zsolt; Jósa, Valeria; Merkel, Keresztely; Zolnai, Zsofia

    2013-01-01

    Although Meckel's diverticulum is the most common congenital gastrointestinal disorder, it is controversial whether asymptomatic diverticula in adults should be respected. The authors report the case of a patient who was operated due to ileus caused by adhesions and a Meckel's diverticulum without any sign of inflammation was accidentally noted and removed. As a surprise, the pathological examination of the diverticulum proved carcinoid tumor, a neuroendocrine malignant tumor. The case raises the importance of the removal of asymptomatic Meckel's diverticulum.

  19. In vitro chemoresistance testing in well differentiated carcinoid tumors.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Well-differentiated, “typical” carcinoid tumors traditionally have a very poor response to chemotherapy. We hypothesized that tumor specimens from well differentiated carcinoid tumors would be highly resistant to the effects of chemotherapy when tested against a variety of antineoplastic agents in v...

  20. Primary pulmonary carcinoid tumor with metastasis to endometrial polyp

    PubMed Central

    Momeni, Mazdak; Kolev, Valentin; Costin, Dan; Mizrachi, Howard H.; Chuang, Linus; Warner, Richard R.P.; Gretz, Herbert F.

    2012-01-01

    INTRODUCTION A carcinoid tumor occurring in the endometrium has been documented in the literature, but there is no report in regard to carcinoid tumor metastasis to endometrium. PRESENTATION OF CASE We report a case of a malignant carcinoid metastasis to an endometrial polyp. Patient underwent hysteroscopy, and polypectomy. The pathology demonstrated an endometrial polyp containing a 4 mm x 5 mm nodule of metastatic carcinoid tumor, consistent with metastasis from patient's known pulmonary carcinoid. The tumor was morphologically similar to the tumors of the right lung, with similar immune-profile. DISCUSSION This patient presented with a suspicious pelvic ultrasound. Due to her age, the first priority was to exclude uterine cancer. The endometrial polyp, which was found, had a small focus of metastatic carcinoid tumor. To the best of our knowledge, this finding has not been previously recorded in the literature. Our patient also had a history of metastatic carcinoid tumor to breast. This finding is also very uncommon. CONCLUSION This is the first case in the literature described a malignant carcinoid metastasis to an endometrial polyp. PMID:23127865

  1. Massive hepatic resection for the carcinoid syndrome

    PubMed Central

    Zeegen, R.; Rothwell-Jackson, R.; Sandler, M.

    1969-01-01

    Removal of the right lobe of the liver which was occupied largely by metastases, together with resection of ileal primary tumours, brought about complete remission of symptoms and signs in a 43-year-old man with a six-year history of the carcinoid syndrome. Investigations should be orientated toward surgery. When practicable, radical surgery of the type described here appears to offer the best hope of alleviating the distressing clinical features of the condition. ImagesFIG. 1aFIG. 1bFIG. 2aFIG. 2bFIG. 3 PMID:5810970

  2. Malignant metastatic carcinoid presenting as brain tumor

    PubMed Central

    Sundar, I. Vijay; Jain, S. K.; Kurmi, Dhrubajyoti; Sharma, Rakesh; Chopra, Sanjeev; Singhvi, Shashi

    2016-01-01

    Carcinoid tumors are rarely known to metastasise to the brain. It is even more rare for such patients to present with symptoms related to metastases as the initial and only symptom. We present a case of a 60-year-old man who presented with hemiparesis and imaging features suggestive of brain tumor. He underwent surgery and the histopathology revealed metastatic malignant lesion of neuroendocrine origin. A subsequent work up for the primary was negative. Patient was treated with adjuvant radiotherapy. We present this case to highlight the pathophysiological features, workup and treatment options of this rare disease and discuss the methods of differentiating it from more common brain tumors. PMID:27366273

  3. Carcinoid of the Appendix During Laparoscopic Cholecystectomy: Unexpected Benefits

    PubMed Central

    Haluck, Randy; Cooney, Robert N.; Minnick, Kathleen E.; Ruggiero, Francesco; Smith, J. Stanley

    1999-01-01

    Carcinoid tumors of the midgut arise from the distal duodenum, jejunum, ileum, appendix, ascending and right transverse colon. The appendix and terminal ileum are the most common location. The majority of carcinoid tumors originate from neuroendocrine cells along the gastrointestinal tract, but they are also found in the lung, ovary, and biliary tracts. We report the first case of elective laparoscopic cholecystectomy in which we found a suspicious lesion at the tip of the appendix and proceeded to perform a laparoscopic appendectomy. The lesion revealed a carcinoid tumor of the appendix. PMID:10323177

  4. [Retrospective evaluation of carcinoid tumors of the appendix in children].

    PubMed

    San Vicente, B; Bardají, C; Rigol, S; Obiols, P; Melo, M; Bella, R

    2009-04-01

    Carcinoids of the appendix are rare in children. Usually diagnosed incidentally on histologic investigation following appendectomy for acute apendicitis. To investigate the significance of the diagnosis of appendiceal carcinoid tumors in children, we conducted a retrospective study in our institution. Between 1990 and 2007 a total of 1158 appendectomy were done. In four patients the diagnosis was appendiceal carcinoid. We studied treatment, follow-up and prognosis of this patients. Indicacion for appendectomy was acute pain in lower right quadrant. The median tumor diameter was lower than 1 cm and the appropriate treatment was appendectomy. The prognosis was excellent in all the patients.

  5. Invasive atypical thymic carcinoid: three case reports and literature review

    PubMed Central

    Zhu, Shan; Wang, Zhong-Tang; Liu, Wen-Zhi; Zong, Shi-Xiang; Li, Bao-Sheng

    2016-01-01

    Atypical thymic carcinoid is an extremely rare thymic neuroendocrine tumor derived from the neuroendocrine system. The aims of this paper were to investigate the clinical features of atypical thymic carcinoid and collate information and experience to improve the diagnosis and treatment of this disease. We describe three cases of atypical carcinoid of the thymus; clinical features, pathological data, treatment modalities, and short-term patient outcomes were summarized and analyzed. The initial clinical symptoms and signs of all three patients were nonspecific and an anterior mediastinal mass was found in each patient on chest computed tomography scan. All three patients underwent surgical resection (total thymectomy and complete excision of the tumor), followed by postoperative radiotherapy, with or without chemotherapy. The diagnoses of three patients were confirmed by pathological and immunohistochemical evaluation. We also present a review of the literature to collate as much information as possible and provide a reference for proper diagnosis and treatment of atypical thyroid carcinoid. PMID:27785065

  6. Endobronchial Carcinoid Tumour with Extensive Ossification: An Unusual Case Presentation.

    PubMed

    Osmond, Allison; Filter, Emily; Joseph, Mariamma; Inculet, Richard; Kwan, Keith; McCormack, David

    2016-01-01

    Carcinoid tumour is a well-known primary endobronchial lung neoplasm. Although calcifications may be seen in up to 30% of pulmonary carcinoid tumours, near complete ossification of these tumours is an unusual finding. Such lesions can prove diagnostically challenging at the time of intraoperative frozen section as the latter technique requires thin sectioning of the lesion for microscopic assessment. We present an unusual case of endobronchial carcinoid tumour with extensive ossification in a 45-year-old male. Preliminary intraoperative diagnosis was achieved through the alternative use of cytology scrape smears. The final diagnosis was confirmed after decalcification of the tumour. The prognostic implications of heavily ossified carcinoid tumours remain elusive. Long-term clinical follow-up of these patients is recommended. PMID:27610135

  7. Frequent mutations in chromatin-remodeling genes in pulmonary carcinoids

    PubMed Central

    Lu, Xin; Sun, Ruping; Ozretić, Luka; Seidal, Danila; Zander, Thomas; Leenders, Frauke; George, Julie; Müller, Christian; Dahmen, Ilona; Pinther, Berit; Bosco, Graziella; Konrad, Kathryn; Altmüller, Janine; Nürnberg, Peter; Achter, Viktor; Lang, Ulrich; Schneider, Peter M; Bogus, Magdalena; Soltermann, Alex; Brustugun, Odd Terje; Helland, Åslaug; Solberg, Steinar; Lund-Iversen, Marius; Ansén, Sascha; Stoelben, Erich; Wright, Gavin M.; Russell, Prudence; Wainer, Zoe; Solomon, Benjamin; Field, John K; Hyde, Russell; Davies, Michael PA.; Heukamp, Lukas C; Petersen, Iver; Perner, Sven; Lovly, Christine; Cappuzzo, Federico; Travis, William D; Wolf, Jürgen; Vingron, Martin; Brambilla, Elisabeth; Haas, Stefan A.; Buettner, Reinhard; Thomas, Roman K

    2014-01-01

    Pulmonary carcinoids are rare neuroendocrine tumors of the lung. The molecular alterations underlying the pathogenesis of these tumors have not been systematically studied so far. Here we perform gene copy number analysis (n=54), genome/exome (n=44) and transcriptome (n=69) sequencing of pulmonary carcinoids and observe frequent mutations in chromatin-remodeling genes. Covalent histone modifiers and subunits of the SWI/SNF complex are mutated in 40% and 22.2% of the cases respectively, with MEN1, PSIP1 and ARID1A being recurrently affected. In contrast to small-cell lung cancer and large-cell neuroendocrine tumors, TP53 and RB1 mutations are rare events, suggesting that pulmonary carcinoids are not early progenitor lesions of the highly aggressive lung neuroendocrine tumors but arise through independent cellular mechanisms. These data also suggest that inactivation of chromatin remodeling genes is sufficient to drive transformation in pulmonary carcinoids. PMID:24670920

  8. Endobronchial Carcinoid Tumour with Extensive Ossification: An Unusual Case Presentation

    PubMed Central

    Filter, Emily; Joseph, Mariamma; Inculet, Richard; Kwan, Keith; McCormack, David

    2016-01-01

    Carcinoid tumour is a well-known primary endobronchial lung neoplasm. Although calcifications may be seen in up to 30% of pulmonary carcinoid tumours, near complete ossification of these tumours is an unusual finding. Such lesions can prove diagnostically challenging at the time of intraoperative frozen section as the latter technique requires thin sectioning of the lesion for microscopic assessment. We present an unusual case of endobronchial carcinoid tumour with extensive ossification in a 45-year-old male. Preliminary intraoperative diagnosis was achieved through the alternative use of cytology scrape smears. The final diagnosis was confirmed after decalcification of the tumour. The prognostic implications of heavily ossified carcinoid tumours remain elusive. Long-term clinical follow-up of these patients is recommended.

  9. Endobronchial Carcinoid Tumour with Extensive Ossification: An Unusual Case Presentation

    PubMed Central

    Filter, Emily; Joseph, Mariamma; Inculet, Richard; Kwan, Keith; McCormack, David

    2016-01-01

    Carcinoid tumour is a well-known primary endobronchial lung neoplasm. Although calcifications may be seen in up to 30% of pulmonary carcinoid tumours, near complete ossification of these tumours is an unusual finding. Such lesions can prove diagnostically challenging at the time of intraoperative frozen section as the latter technique requires thin sectioning of the lesion for microscopic assessment. We present an unusual case of endobronchial carcinoid tumour with extensive ossification in a 45-year-old male. Preliminary intraoperative diagnosis was achieved through the alternative use of cytology scrape smears. The final diagnosis was confirmed after decalcification of the tumour. The prognostic implications of heavily ossified carcinoid tumours remain elusive. Long-term clinical follow-up of these patients is recommended. PMID:27610135

  10. A rare case of carcinoid tumor in a tailgut cyst

    PubMed Central

    Jehangir, Asad; Le, Brian H.; Carter, Frank M

    2016-01-01

    Tailgut cysts are rare congenital lesions that arise from the failure of regression of the embryological tailgut. We report a case of neoplastic transformation of tailgut cyst to carcinoid tumor which is exceedingly uncommon. PMID:27406449

  11. Diagnosis and Management of Hereditary Carcinoids.

    PubMed

    Benafif, Sarah; Eeles, Rosalind

    2016-01-01

    Carcinoid tumours arise in cells of the diffuse neuroendocrine system and can develop in a number of anatomical sites including the lungs and the gastrointestinal tract. There has been a move away from the use of the term carcinoid tumour to the more appropriate use of neuroendocrine tumour (NET) to highlight the potential for invasion and metastasis associated with some NETs. Although most cases are sporadic, 15-20% of cases are related to a hereditary syndrome, the most common of these being multiple endocrine neoplasia 1 (MEN1). Other hereditary syndromes include the following: von Hippel-Lindau (VHL), neurofibromatosis 1 and tuberous sclerosis complex (TSC), which are all associated with a germline mutation of the associated tumour suppressor gene and an autosomal dominant inheritance pattern. Familial small intestinal NET (SI NET) is a recently described condition which is also inherited in an autosomal dominant manner. There appears to be more than one causative gene; thus far, only the IPMK gene has been identified as a causative germline mutation. This was identified by carrying out whole-exome sequencing of germline and tumour DNA in a family with multiple members diagnosed with SI NET. Identification of NET predisposition genes in other families via these methods will allow the development of dedicated NET gene panels which can be used to screen NET patients and at-risk relatives for hereditary mutations. Close surveillance of at-risk individuals is important to detect NETs early when curative surgery can be offered and the morbidity and mortality of metastatic NETs can be avoided. PMID:27075353

  12. Rectal Mechano-sensory Function in Patients with Carcinoid Diarrhea

    PubMed Central

    Gregersen, Tine; Brock, Christina; Haase, Anne-Mette; Laurberg, Søren; Drewes, Asbjørn M; Grønbæk, Henning; Krogh, Klaus

    2016-01-01

    Background/Aims In patients with neuroendocrine tumors, excessive production of serotonin and other amines may cause the carcinoid syndrome, which is mainly characterized by diarrhea and flushing. Little is known about the pathophysiology of carcinoid diarrhea. In several other groups of patients, diarrhea may be associated with rectal hypersensitivity and increased rectal tone. Therefore, the aim of the present study was to compare rectal sensitivity and compliance in patients with carcinoid diarrhea and in healthy subjects. Methods Twelve patients (6 males, aged 54–78 years, median 65 years), with carcinoid diarrhea and 19 healthy subjects (7 males, aged 50–78 years, median 61 years) were included. Rectal mechanical and heat stimulation was used for assessment of rectal mechano-sensory properties. Results Overall, 5.3% higher temperatures were needed to elicit sensory responses in patients with carcinoid diarrhea than in healthy subjects (P = 0.015). Posthoc analyses revealed that the sensory threshold to heat was 48.1 ± 3.1°C in patients vs 44.7 ± 4.7°C in healthy subjects (P = 0.041). In contrast, patients and healthy subjects showed no overall differences in rectal sensory response to mechanical distension (P = 0.731) or rectal compliance (P = 0.990). Conclusions Patients with carcinoid diarrhea have higher sensory thresholds to heat stimulation in comparison to healthy subjects, but normal rectal sensation to mechanical distension and normal compliance. Therefore, treatment of carcinoid diarrhea should aim at prolonging gastrointestinal transit and decreasing secretion, rather than modifying rectal mechano-sensory function. PMID:26690884

  13. Transcatheter Pulmonary Valve Replacement in a Carcinoid Heart

    PubMed Central

    Loyalka, Pranav; Schechter, Michael; Nascimbene, Angelo; Raman, Ajay Sundara; Ilieascu, Cezar A.; Gregoric, Igor D.

    2016-01-01

    Carcinoid heart disease presents as right-sided heart failure attributable to the dysfunction of the tricuspid and pulmonary valves. Although surgical valve replacement is the mainstay of treatment when patients become symptomatic, it is associated with substantial perioperative mortality rates. We present a case of severe pulmonary valve stenosis secondary to carcinoid heart disease, treated successfully with percutaneous valve replacement. A 67-year-old man with severe pulmonary valve stenosis was referred to our center for pulmonary valve replacement. The patient had a history of metastatic neuroendocrine tumor of the small bowel with carcinoid syndrome, carcinoid heart disease, and tricuspid valve regurgitation previously treated with surgical valve replacement. Because of the patient's severe chronic obstructive pulmonary disease and hostile chest anatomy seen on a computed tomographic scan dating from previous cardiothoracic surgery, we considered off-label percutaneous valve replacement a viable alternative to open-heart surgery. A 29-mm Edwards Sapien XT valve was successfully deployed over the native pulmonary valve. There were no adverse sequelae after the procedure, and the patient was discharged from the hospital the next day. This case report shows that percutaneous valve replacement can be a valid option in carcinoid heart disease patients who are not amenable to surgical valve replacement. PMID:27547148

  14. Ovarian strumal carcinoid producing peptide YY associated with severe constipation: a case report and review of the literature.

    PubMed

    Muller, Kristen E; Tafe, Laura J; Gonzalez, Jorge L; West, Loyd A; Schned, Alan R

    2015-01-01

    Primary carcinoid tumors are rare neoplasms of the ovary. Of the 4 histologic subtypes, ovarian carcinoid tumors with insular patterns produce carcinoid syndrome in approximately one third of cases, versus strumal and trabecular carcinoids which very rarely cause typical carcinoid syndrome. A unique presentation of ovarian carcinoid tumors with concurrent severe constipation has been reported, which is thought to represent a new carcinoid syndrome. The proposed mechanism is the production of peptide YY by the tumor, a gastrointestinal hormone responsible for decreasing gut motility. We report a case of a 34-yr-old white woman who presented with constipation and weight loss for 1 yr, and was found to have a unilateral ovarian strumal carcinoid, which produced peptide YY as demonstrated by immunohistochemistry. The 13 previous case reports of ovarian carcinoids with constipation are reviewed and the clinicopathologic features are discussed. This report and literature review further solidifies this entity as a new type of carcinoid syndrome.

  15. A case of multicentric carcinoid in a patient with psoriatic spondyloarthropathy.

    PubMed

    George, Nabil; Depala, Archana; Al Sweedan, Laith; Chakravarty, Kuntal

    2015-01-01

    We describe the first case of a patient presenting with multicentric carcinoid occurring in the lung and subsequently in the rectum, with chronic psoriatic arthritis. Although reports have been published regarding carcinoid syndrome occurring alongside rheumatoid arthritis, no reports have been made on such a case. Initial presentation of carcinoid syndrome in this patient was insidious and atypical with few symptoms, including shortness of breath and long standing abdominal bloating. Several years later a sudden change in bowel habit prompted a colonoscopy with biopsy that revealed a carcinoid rectal polyp. The case we report describes a rare presentation of carcinoid syndrome in chronic psoriatic arthropathy.

  16. A Case of Multicentric Carcinoid in a Patient with Psoriatic Spondyloarthropathy

    PubMed Central

    George, Nabil; Depala, Archana; Al Sweedan, Laith; Chakravarty, Kuntal

    2015-01-01

    We describe the first case of a patient presenting with multicentric carcinoid occurring in the lung and subsequently in the rectum, with chronic psoriatic arthritis. Although reports have been published regarding carcinoid syndrome occurring alongside rheumatoid arthritis, no reports have been made on such a case. Initial presentation of carcinoid syndrome in this patient was insidious and atypical with few symptoms, including shortness of breath and long standing abdominal bloating. Several years later a sudden change in bowel habit prompted a colonoscopy with biopsy that revealed a carcinoid rectal polyp. The case we report describes a rare presentation of carcinoid syndrome in chronic psoriatic arthropathy. PMID:25802789

  17. Carcinoid Tumour of Caecum: an Unusual Palpable Mass in the Right Iliac Fossa.

    PubMed

    Agrawal, Mohit M; Sude, Nandkishor S

    2016-04-01

    Carcinoid tumour represents 0.8-1.5 % of malignant digestive tumours. Gastrointestinal (GI) carcinoids account for 95 % of all the carcinoids, and caecal carcinoids account for 5 % of all the carcinoids. These tumours are frequent in women (2-4:1) as reported by Spallitta and Termine (Minerva Chir 55:77-87, 2002). In order of frequency, they may occur in the appendix (35 %), ileum (28 %), rectum (13 %) and bronchi. Incidence is less than 1 % in the pancreas, gall bladder, liver, larynx, testes and ovaries. The colon and ileocaecal region are rare sites of origin for gastrointestinal carcinoids as reported by Soga (J Exp Clin Cancer Res 17:139-48, 1998). They remain asymptomatic for years and many a times are diagnosed endoscopically, intraoperatively or during autopsy, based on their histopathological findings. We present a rare case of caecal carcinoid. PMID:27303130

  18. ACTH producing pulmonary carcinoid and pituitary macroadenoma: a fortuitous association?

    PubMed

    Wong, M; Isa, S H Md; Kamaruddin, N A; Khalid, B A K

    2007-06-01

    We report a case of a 45 year-old man who presented initially with a non-functioning pituitary macroadenoma. A routine chest radiography done preoperatively revealed a right lung nodule which was confirmed by computed tomography (CT) of the thorax. Transfrontal hypophysectomy was performed while a conservative approach was taken for the lung nodule. Four years later, he presented acutely with adrenocorticotrophic hormone (ACTH) dependent Cushing's syndrome which resolved following a right lobectomy. Histological examination revealed an atypical carcinoid. To our knowledge, this is the first reported case of an ectopic ACTH secreting pulmonary carcinoid found in association with a non-functioning pituitary macroadenoma.

  19. Genetics of neuroendocrine and carcinoid tumours.

    PubMed

    Leotlela, P D; Jauch, A; Holtgreve-Grez, H; Thakker, R V

    2003-12-01

    Neuroendocrine tumours (NETs) originate in tissues that contain cells derived from the embryonic neural crest, neuroectoderm and endoderm. Thus, NETs occur at many sites in the body, although the majority occur within the gastro-entero-pancreatic axis and can be subdivided into those of foregut, midgut and hindgut origin. Amongst these, only those of midgut origin are generally argentaffin positive and secrete serotonin, and hence only these should be referred to as carcinoid tumours. NETs may occur as part of complex familial endocrine cancer syndromes, such as multiple endocrine neoplasia type 1 (MEN1), although the majority occur as non-familial (i.e. sporadic) isolated tumours. Molecular genetic studies have revealed that the development of NETs may involve different genes, each of which may be associated with several different abnormalities that include point mutations, gene deletions, DNA methylation, chromosomal losses and chromosomal gains. Indeed, the foregut, midgut and hindgut NETs develop via different molecular pathways. For example, foregut NETs have frequent deletions and mutations of the MEN1 gene, whereas midgut NETs have losses of chromosome 18, 11q and 16q and hindgut NETs express transforming growth factor-alpha and the epidermal growth factor receptor. Furthermore, in lung NETs, a loss of chromosome 3p is the most frequent change and p53 mutations and chromosomal loss of 5q21 are associated with more aggressive tumours and poor survival. In addition, methylation frequencies of retinoic acid receptor-beta, E-cadherin and RAS-associated domain family genes increase with the severity of lung NETs. Thus the development and progression of NETs is associated with specific genetic abnormalities that indicate the likely involvement of different molecular pathways.

  20. A thymic carcinoid in a Bengal tiger (Panthera tigris).

    PubMed

    Powe, Joshua; Castleman, William; Fiorello, Christine

    2005-09-01

    An 18-yr-old Bengal tiger (Panthera tigris) presented with acute onset hind limb paresis. Radiographic and ultrasonographic imaging revealed a caudal abdominal aortic thrombus and a cranial mediastinal mass. Necropsy confirmed aortic thrombosis. Necrotizing enteritis and multifocal renal thrombosis were also noted. The cranial mediastinum contained a bilobed mass that histologically and ultrastructurally was consistent with a carcinoid.

  1. Unusual presentation of carcinoid tumor as acute cholecystitis

    SciTech Connect

    Saxton, C.R.

    1983-07-01

    The patient described had signs, symptoms, and laboratory data consistent with acute cholecystitis. A sonogram also suggested cholecystitis, and the gallbladder was not displayed by nuclear imaging. Cholecystectomy revealed the absence of stones but showed carcinoid tumor metastatic to the gallbladder.

  2. A thymic carcinoid in a Bengal tiger (Panthera tigris).

    PubMed

    Powe, Joshua; Castleman, William; Fiorello, Christine

    2005-09-01

    An 18-yr-old Bengal tiger (Panthera tigris) presented with acute onset hind limb paresis. Radiographic and ultrasonographic imaging revealed a caudal abdominal aortic thrombus and a cranial mediastinal mass. Necropsy confirmed aortic thrombosis. Necrotizing enteritis and multifocal renal thrombosis were also noted. The cranial mediastinum contained a bilobed mass that histologically and ultrastructurally was consistent with a carcinoid. PMID:17312779

  3. Thymic carcinoids in multiple endocrine neoplasia type 1.

    PubMed Central

    Teh, B T; Zedenius, J; Kytölä, S; Skogseid, B; Trotter, J; Choplin, H; Twigg, S; Farnebo, F; Giraud, S; Cameron, D; Robinson, B; Calender, A; Larsson, C; Salmela, P

    1998-01-01

    OBJECTIVE: To study the clinical, pathologic, and genetic features of thymic carcinoids in the setting of multiple endocrine neoplasia type 1 (MEN1) and to study means for detection and prevention of this tumor in patients with MEN1. SUMMARY BACKGROUND DATA: Thymic carcinoid is a rare malignancy, with approximately 150 cases reported to date. It may be associated with MEN1 and carries a poor prognosis, with no effective treatment. Its underlying etiology is unknown. METHODS: Ten patients with MEN1 from eight families with anterior mediastinal tumors were included in a case series study at tertiary referring hospitals. Clinicopathologic studies were done on these patients, with a review of the literature. Mutation analysis was performed on the MEN1 gene in families with clusterings of the tumor to look for genotype-phenotype correlation. Loss of heterozygosity was studied in seven cases to look for genetic abnormalities. RESULTS: Histologic studies of all tumors were consistent with the diagnosis of thymic carcinoid. Clustering of this tumor was found in some of the families-three pairs of brothers and three families with first- or second-degree relatives who had thymic carcinoid. All patients described here were men, with a mean age at detection of 44 years (range 31 to 66). Most of the patients had chest pain or were asymptomatic; none had Cushing's or carcinoid syndrome. All tumors were detected by computed tomography (CT) or magnetic resonance imaging (MRI) of the chest. The results of octreoscans performed in three patients were all positive. Histopathologic studies were consistent with the diagnosis of thymic carcinoid and did not stain for ACTH. Mutation analysis of the families with clustering revealed mutations in different exons/introns of the MEN1 gene. Loss of heterozygosity (LOH) studies of seven tumors did not show LOH in the MEN1 region, but two tumors showed LOH in the 1p region. CONCLUSIONS: MEN1-related thymic carcinoids constitute approximately 25

  4. Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids

    PubMed Central

    Wang, Kui-Rong; Jia, Yuan-Jing; Zhou, Shui-Hong; Wang, Qin-Ying; Bao, Yang-Yang; Feng, Zhi-Ying; Yao, Hong-Tian; Fan, Jun

    2016-01-01

    Abstract The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No

  5. Prognosis of patients with carcinoid heart disease after valvular surgery.

    PubMed

    Manoly, Imthiaz; McAnelly, Sarah-Louise; Sriskandarajah, Sanjeevan; McLaughlin, Kenneth Edward

    2014-08-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. We addressed the following question: in patients who are diagnosed with carcinoid heart disease (CHD), do valvular surgeries improve their prognosis? Fifty percent of the patients with clinically diagnosed carcinoid syndrome had cardiac involvement which was present either as valvular dysfunction or as cardiac metastases. These patients often require surgery due to their heightened risk of cardiac disease. Altogether 217 relevant papers were identified as a result of the below-mentioned search, of which 10 papers represented the best evidence to answer the question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses were tabulated. Of the patients who were identified to have carcinoid heart disease in different studies, 193 patients had valve procedure, mainly replacements at tricuspid, mitral and aortic valve positions and either valvuloplasty or replacement at pulmonary valve. Tricuspid and pulmonary valves represented the majority of the excised valves among patients undergoing valvular surgery for CHD. The pathology of carcinoid valve was attributed to the presence of plaque, causing thickening and retraction. Pure regurgitation was the most common finding in all the valves except pulmonary valve which had both stenosis and insufficiency. Thirty-day mortality was 17% (range 1-63%) and long-term survivors were reported to be alive at an average of 58 months (28-80 months) after the valve surgery. The evidence demonstrates that surgical intervention can lead to improved prognosis and reduce the symptoms of heart failure. Postoperative mortality was mainly due to the carcinoid disease itself and not as a complication of the surgery. Therefore, surgery could be considered for symptomatic palliation in carefully selected individuals.

  6. Complicaciones gastrointestinales (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca del estreñimiento, la retención fecal, la obstrucción intestinal y la diarrea como complicaciones del cáncer o su tratamiento. Se discute el manejo de estos problemas.

  7. Carcinoid heart disease from ovarian primary presenting with acute pericarditis and biventricular failure

    PubMed Central

    Vergani, D; Massironi, L; Lombardi, F; Fiorentini, C

    1998-01-01

    A case is described of a 54 year old woman who had acute pericarditis with large exudative effusion accompanied by severe right and left ventricular failure. The patient was finally diagnosed with carcinoid heart disease from an ovarian carcinoid teratoma. She was treated with octreotide—a somatostatin analogue—followed by radical surgical resection of the neoplasm. At one year follow up only mild carcinoid tricuspid regurgitation remained. Only 16 cases of carcinoid heart disease from an ovarian primary have been described in literature. Moreover clinically manifest acute, non-metastatic pericarditis and left heart failure are not considered as possible presentations of carcinoid heart disease, whatever the origin. In a recent series a small pericardial effusion was considered an infrequent and unexpected echocardiographic finding in carcinoid heart patients. One case of "carcinoid pericarditis" has previously been described as a consequence of pericardial metastasis. Left sided heart involvement is usually caused by bronchial carcinoids or patency of foramen ovale; both were excluded in the case presented.

 Keywords: carcinoid heart disease;  ovarian tumour;  acute pericarditis;  heart failure PMID:10065036

  8. Primary hepatic carcinoid tumor: case report and literature review

    PubMed Central

    Camargo, Éden Sartor; Viveiros, Marcelo de Melo; Corrêa, Isaac José Felippe; Robles, Laercio; Rezende, Marcelo Bruno

    2014-01-01

    Primary hepatic carcinoid tumors are extremely rare neoplasms derived from hormone-producing neuroendocrine cells. It is difficult to make their diagnosis before biopsy, surgical resection or necropsy. A recent publication described only 94 cases of these tumors. There is no sex predilection and apparently it has no association with cirrhosis or preexisting hepatic disease. The most effective treatment is hepatectomy, and resection is determined by size and location of the lesions. PMID:25628206

  9. Paraneoplastic neuromyelitis optica spectrum disorder associated with stomach carcinoid tumor.

    PubMed

    Al-Harbi, Talal; Al-Sarawi, Adnan; Binfalah, Mohamed; Dermime, Said

    2014-09-01

    Neuromyelitis optica (NMO), or Devic's syndrome, is an autoimmune central nervous system demyelinating disorder primarily affecting the spinal cord and the optic nerves. It is characterized by the presence of NMO antibodies, alongside clinical and radiological findings. NMO and NMO-spectrum disorders (NMO-SD) have been reported in autoimmune disorders, and are infrequently described as a paraneoplastic syndrome with cancers of lung, breast, and carcinoid tumors of the thyroid. We report a patient who presented with severe vomiting, blurring of vision, vertigo, diplopia, left hemiparesis and hemisensory loss and ataxia. She was found to have a longitudinally-extensive demyelinating lesion extending from the medulla to the upper cervical spinal cord on MRI. Her gastric endoscopy revealed carcinoid tumor of the stomach, and classic paraneoplastic antibodies in the serum were negative. She had extremely high serum gastrin level and high titer of NMO IgG autoantibody. The patient made an excellent recovery with tumor resection and immunotherapy, with both clinical and radiological improvement. On rare instances, NMO or NMO-SD may present as a paraneoplastic neurological syndrome associated with carcinoid tumor of the stomach.

  10. Marital Status and Survival in Patients with Carcinoid Tumors

    PubMed Central

    Greenleaf, Erin K.; Cooper, Amanda B.; Hollenbeak, Christopher S.

    2016-01-01

    BACKGROUND Marital status is a known prognostic factor in overall and disease-specific survival in several types of cancer. The impact of marital status on survival in patients with carcinoid tumors remains unknown. We hypothesized that married patients have higher rates of survival than similar unmarried patients with carcinoid tumors. METHODS Using the Surveillance, Epidemiology, and End Results database, we identified 23,126 people diagnosed with a carcinoid tumor between 2000 and 2011 and stratified them according to marital status. Univariate and multivariable analyses were performed to compare the characteristics and outcomes between patient cohorts. Overall and cancer-related survival were analyzed using the Kaplan–Meier method. Multivariable survival analyses were performed using Cox proportional hazards models (hazards ratio [HR]), controlling for demographics and tumor-related and treatment-related variables. Propensity score analysis was performed to determine surgical intervention distributions among married and unmarried (ie, single, separated, divorced, widowed) patients. RESULTS Marital status was significantly related to both overall and cancer-related survival in patients with carcinoid tumors. Divorced and widowed patients had worse overall survival (HR, 1.33 [95% confidence interval {CI}, 1.08–1.33] and 1.34 [95% CI, 1.22–1.46], respectively) and cancer-related survival (HR, 1.15 [95% CI, 1.00–1.31] and 1.15 [95% CI, 1.03–1.29], respectively) than married patients over five years. Single and separated patients had worse overall survival (HR, 1.20 [95% CI, 1.08–1.33] and 1.62 [95% CI, 1.25–2.11], respectively) than married patients over five years, but not worse cancer-related survival. Unmarried patients were more likely than matched married patients to undergo definitive surgical intervention (62.67% vs 53.11%, respectively, P < 0.0001). CONCLUSIONS Even after controlling for other prognostic factors, married patients have a

  11. Gastrointestinal carcinoid tumor and chylous ascites, a rare association with a poor prognosis. A case report.

    PubMed

    Portale, Teresa Rosanna; Mosca, Francesco; Minona, Elisa; Trovato, Maria Antonietta; Gangemi, Pietro; Bordonaro, Roberto; Puleo, Stefano

    2008-01-01

    Gastrointestinal carcinoid is a rare tumor. The association of this tumor with chylous ascites is uncommon. A review of the English-language literature carried out in 2002 identified only 15 cases. We report a case of chylous ascites, gastrointestinal carcinoid tumor and elevated blood levels of CA-125 in a patient who did not respond to chemotherapy.

  12. The cost-effectiveness of octreotide acetate in the treatment of carcinoid syndrome and VIPoma.

    PubMed

    Schonfeld, W H; Eikin, E P; Woltering, E A; Modlin, I M; Anthony, L; Villa, K F; Zagari, M

    1998-01-01

    Markov modeling was used to evaluate the cost-effectiveness of octreotide in treating carcinoid syndrome and VIPoma. For each condition, using octreotide was associated with doubled survival time. Octreotide was cost-effective for treating carcinoid tumor ($752 per additional year of life, two additional years on average), and cost saving for VIPoma.

  13. Case of peptide-YY-producing strumal carcinoid of the ovary: a case report and review.

    PubMed

    Takatori, Eriko; Shoji, Tadahiro; Miura, Jiyu; Takeuchi, Satoshi; Yoshizaki, Akira; Sugiyama, Toru

    2012-10-01

    Ovarian carcinoid is a rare tumor accounting for approximately 0.1% of all ovarian malignancies. We describe a case of peptide-YY-producing strumal carcinoid of the ovary associated with severe constipation. A 48-year-old woman was found to have a pelvic mass on ultrasonography when she visited her primary doctor for a health check-up. She was thus referred to our department. Magnetic resonance imaging revealed a solid right ovarian tumor 60 × 50 mm in size. The patient underwent a right adnexectomy and was histopathologically diagnosed as having strumal carcinoid of the ovary. On immunohistochemical examination, the tumor cells were positive for peptide YY. The patient's constipation resolved rapidly after surgery. Based on her clinical course, her constipation was considered to have been caused by the strumal carcinoid of the ovary. The clinical course of this case supports the previously recognized correlation between peptide-YY-producing ovarian carcinoid and constipation.

  14. Carcinoid tumour of appendix in a child: a rare case at an uncommon site.

    PubMed

    Vani, B R; Thejaswini, M U; Kumar, B Deepak; Murthy, V Srinivasa; Geethamala, K

    2014-01-01

    Carcinoid tumours of the appendix are uncommon incidentally detected tumours during histopathological examination following appendicectomy for acute appendicitis. Even though considered rare in children, they are the most frequently encountered tumours of the gastrointestinal tract. To our knowledge, carcinoid tumour of appendix in childhood has not yet been reported from Indian Subcontinent. The clinical presentation is similar to acute appendicitis and the signs and symptoms of carcinoid syndrome have not been reported in children. The prognosis of carcinoid tumour of appendix is excellent in children as the tumour is generally small in size and less aggressive with no metastasis. Simple appendicectomy is curative in most of the patients and long term follow up is debatable. We present here a case of carcinoid tumour of the body of appendix, which is an uncommon location in a 6-year-old child.

  15. Primary lung carcinoid, a rare cause of paraparesis: report of a case and review of the literature

    PubMed Central

    Visouli, Aikaterini N.; Darwiche, Kaid; Kourtoglou, Georgios I.; Mpakas, Andreas; Machairiotis, Nikolaos; Stylianaki, Aikaterini; Christofis, Chistos; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Courcoutsakis, Nicolaos; Zarogoulidis, Konstantinos

    2012-01-01

    Carcinoids are neuroendocrine tumors mainly involving the gastrointestinal tract, lungs and bronchi. They were considered benign with slow growth, but they can be malignant in a substantial percentage of patients (metastasizing to liver, bones, skin, etc). Endocrine activity results in carcinoid syndrome. Proximal myopathy has been reported in 7% of patients with carcinoid syndrome. Bronchopulmonary and thymic carcinoids producing adrenocorticotropic hormone can cause Cushing’s syndrome, a main feature of which is myopathy. There are a few reports of carcinoids associated with paraneoplastic neurological syndromes, including neuropathy. We hereby present an extremely rare case of a primary lung carcinoid presented with paraparesis due to polyneuropathy, and review the relevant literature. To the best of our knowledge there is no similar previous report. Complete resolution of paraparesis after excision of the lung carcinoid suggests paraneoplastic neurological syndrome. PMID:23304441

  16. Complications from carcinoid syndrome: review of the current evidence

    PubMed Central

    Mota, José Mauricio; Sousa, Luana Guimarães; Riechelmann, Rachel P

    2016-01-01

    Patients with well-differentiated neuroendocrine tumours may develop carcinoid syndrome (CS), which is characterised by flushing, abdominal cramps, diarrhoea, and bronchospasms. In this scenario, long-term secretion of vasoactive substances—serotonin, tachynins, and others, may induce fibrogenic responses in local or distant tissues, leading to complications such as carcinoid heart disease (CHD), mesenteric and/or retroperitoneal fibrosis. Rare cases of lung/pleural fibrosis and scleroderma have also been described. Despite it not being well described yet, current evidence suggests the pathogenesis of such fibrogenic complications relies on signalling through 5-HT2B and TGF-β1. Medical management is still very limited and lacks prospective and randomised studies for definitive recommendations. Surgical procedures remain the best definitive treatment option for CHD and abdominal fibrosis. Recently, cognitive impairment has also been described as a potential consequence of CS. This review critically discusses the literature concerning the epidemiology, pathogenesis, clinical features, diagnosis, and treatment options for CS-related long-term complications. PMID:27594907

  17. Complications from carcinoid syndrome: review of the current evidence

    PubMed Central

    Mota, José Mauricio; Sousa, Luana Guimarães; Riechelmann, Rachel P

    2016-01-01

    Patients with well-differentiated neuroendocrine tumours may develop carcinoid syndrome (CS), which is characterised by flushing, abdominal cramps, diarrhoea, and bronchospasms. In this scenario, long-term secretion of vasoactive substances—serotonin, tachynins, and others, may induce fibrogenic responses in local or distant tissues, leading to complications such as carcinoid heart disease (CHD), mesenteric and/or retroperitoneal fibrosis. Rare cases of lung/pleural fibrosis and scleroderma have also been described. Despite it not being well described yet, current evidence suggests the pathogenesis of such fibrogenic complications relies on signalling through 5-HT2B and TGF-β1. Medical management is still very limited and lacks prospective and randomised studies for definitive recommendations. Surgical procedures remain the best definitive treatment option for CHD and abdominal fibrosis. Recently, cognitive impairment has also been described as a potential consequence of CS. This review critically discusses the literature concerning the epidemiology, pathogenesis, clinical features, diagnosis, and treatment options for CS-related long-term complications.

  18. Complications from carcinoid syndrome: review of the current evidence.

    PubMed

    Mota, José Mauricio; Sousa, Luana Guimarães; Riechelmann, Rachel P

    2016-01-01

    Patients with well-differentiated neuroendocrine tumours may develop carcinoid syndrome (CS), which is characterised by flushing, abdominal cramps, diarrhoea, and bronchospasms. In this scenario, long-term secretion of vasoactive substances-serotonin, tachynins, and others, may induce fibrogenic responses in local or distant tissues, leading to complications such as carcinoid heart disease (CHD), mesenteric and/or retroperitoneal fibrosis. Rare cases of lung/pleural fibrosis and scleroderma have also been described. Despite it not being well described yet, current evidence suggests the pathogenesis of such fibrogenic complications relies on signalling through 5-HT2B and TGF-β1. Medical management is still very limited and lacks prospective and randomised studies for definitive recommendations. Surgical procedures remain the best definitive treatment option for CHD and abdominal fibrosis. Recently, cognitive impairment has also been described as a potential consequence of CS. This review critically discusses the literature concerning the epidemiology, pathogenesis, clinical features, diagnosis, and treatment options for CS-related long-term complications. PMID:27594907

  19. Association synchrone d'un cancer du sein bilatéral et d'une tumeur stromale gastro-intestinale: à propos d'un rare cas

    PubMed Central

    Afif, Mohammed; Ouziane, Imane; Kouhen, Fadila; Khalil, Jihane; Elomrani, Fedwa; Elkacemi, Hanan; Kebdani, Tayeb; Errihani, Hassan; Benjaafar, Noureddine

    2015-01-01

    Les tumeurs stromales gastro-intestinales sont les tumeurs mésenchymateuses les plus fréquentes, pourtant, leur association avec les tumeurs du sein sont rares, seulement quelques cas cliniques sont rapportés dans la littérature. Nous rapportons l'observation d'une jeune femme de 41 ans, suivie à l'institut national d'oncologie de Rabat, pour un carcinome canalaire du sein, bilatéral, chez qui le bilan d'extension a objectivé une tumeur stromale de type gastro-intestinale aux dépens de l'estomac. Nous décrivons à travers cette observation les aspects épidémiologiques, cliniques, et les particularités de la prise en charge de cette association rare. PMID:26090003

  20. Primary carcinoid tumors of the testis: a clinicopathologic study of 29 cases.

    PubMed

    Wang, Wenle P; Guo, Charles; Berney, Daniel M; Ulbright, Thomas M; Ubright, Thomas M; Hansel, Donna E; Shen, Rulong; Ali, Tehmina; Epstein, Jonathan I

    2010-04-01

    Testicular carcinoid tumors are rare with only limited studies. We identified 29 primary testicular carcinoid cases from 7 academic institutions. Patients ranged in age from 12 to 65 years old (mean 36). The most common presenting symptom was the sole finding of either a testicular mass or swelling seen in 15/24 cases with available information. The next most common mode of presentation was as an incidental finding seen in 6 cases. Two patients had carcinoid syndrome including diarrhea, hot flashes, and palpitations. Nineteen were pure carcinoid tumors, 3 were associated with cystic teratoma, 2 with cysts lacking epithelial lining, 4 with epidermoid cyst, and 1 with dermoid cyst. The mean size was 2.5 cm. All 29 primary carcinoids lacked associated intratubular germ cell neoplasia, unclassified type. Mitotic figures were rare in primary carcinoid tumors with only 3 cases showing more than 2 per 10 HPF; necrosis was found in only 1 case. Random scattered mild to moderate nuclear atypia was seen in 12/29 cases. Of the 28 cases found premortem, treatment included focal excision in 3 patients and radical orchiectomy in 25 patients. Follow-up, available in 24 cases, ranged from 1 to 228 months (mean 52.7 mo); of the 20 patients with testicular typical carcinoid tumors found premortem, all were alive at last follow-up without recurrences or metastases. Of the 4 patients with a primary atypical carcinoid tumor, 1 at the time of diagnosis had retroperitoneal and lung metastases who after chemotherapy underwent resection of the retroperitoneal tumor showing metastatic yolk sac tumor and embryonal carcinoma. After resection, serum AFP levels remained elevated and the patient is scheduled for salvage chemotherapy and bone marrow transplant. The other 2 patients with atypical carcinoid and follow-up had no evidence of disease at 68 and 114 months. Most primary carcinoid tumors of the testis have a benign clinical course even if associated with epidermoid/dermoid cysts, or

  1. Thiocoraline activates the Notch pathway in carcinoids and reduces tumor progression in vivo

    PubMed Central

    Wyche, Thomas P.; Dammalapati, Ajitha; Cho, Hyunah; Harrison, April D.; Kwon, Glen S.; Chen, Herbert; Bugni, Tim S.; Jaskula-Sztul, Renata

    2014-01-01

    Carcinoids are slow-growing neuroendocrine tumors (NETs) that are characterized by hormone overproduction; surgery is currently the only option for treatment. Activation of the Notch pathway has previously been shown to have a role in tumor suppression in NETs. The marine-derived thiodepsipeptide thiocoraline was investigated in vitro in two carcinoid cell lines (BON and H727). Carcinoid cells treated with nanomolar concentrations of thiocoraline resulted in a decrease in cell proliferation and an alteration of malignant phenotype evidenced by decrease of NET markers, ASCL-1, CgA, and NSE. Western blot analysis demonstrated the activation of Notch1 on the protein level in BON cells. Additionally, thiocoraline activated downstream Notch targets HES1, HES5, and HEY2. Thiocoraline effectively suppressed carcinoid cell growth by promoting cell cycle arrest in BON and H727 cells. An in vivo study demonstrated that thiocoraline, formulated with polymeric micelles, slowed carcinoid tumor progression. Thus, the therapeutic potential of thiocoraline, which induced activation of the Notch pathway, in carcinoid tumors was demonstrated. PMID:25412645

  2. Expression of neurotensin messenger RNA in a human carcinoid tumor.

    PubMed Central

    Evers, B M; Ishizuka, J; Townsend, C M; Rajaraman, S; Thompson, J C

    1991-01-01

    Neurotensin (NT), a distal gut peptide, has important regulatory and trophic effects throughout the gut; however the intracellular mechanisms that regulate the gene expression and release of human NT are not known. The purpose of this endeavor was to study a functioning human pancreatic carcinoid cell line (called BON) in vitro that expresses the NT gene, and to study the effect of the cyclic adenosine monophosphate (cAMP) signal-transduction pathway on the expression and release of human NT. RNA was prepared from BON cell line (which has been established in this laboratory); the RNA was analyzed for NT mRNA expression by Northern hybridization with a complementary DNA probe. RNA blot analysis demonstrated that the NT gene is expressed in BON and is transcribed to two mRNAs of 1.0- and 1.5-kb sizes. In the second part of this study, BON cells were treated with either forskolin (FSK), which increases intracellular levels of cAMP, or with serotonin (5-HT), which reduces cAMP in BON cells. Forskolin produced a dose-dependent increase in NT peptide release and, furthermore, FSK (10(-6) mol/L) rapidly increased NT mRNA abundance 1 hour after addition; conversely, 5-HT (10(-5) mol/L) decreased NT mRNA at 1 hour. Neurotensin mRNA levels returned to control values by 3 hours after either FSK or 5-HT, which suggests that the transcript half-life for NT is relatively short. These findings show that the expression and peptide release of human NT is mediated, in part, by the cAMP signal-transduction pathway. Our human carcinoid cell line will provide a useful model to study the in vitro regulation of NT gene expression and peptide release. Images Fig. 1. Fig. 2. Fig. 3. Fig. 5. Fig. 6. PMID:1659338

  3. Bronchial carcinoid tumors metastatic to the sella turcica and review of the literature.

    PubMed

    Moshkin, Olga; Rotondo, Fabio; Scheithauer, Bernd W; Soares, Mark; Coire, Claire; Smyth, Harley S; Goth, Miklos; Horvath, Eva; Kovacs, Kalman

    2012-06-01

    We review here the literature on neuroendocrine neoplasms metastatic to the pituitary and present an example of the disease. Metastasis of bronchial carcinoid tumors to the sellar region are rare. Herein, we describe the case of a 63-year-old woman who presented with constant cough and headaches. She had previously been operated for carcinoid tumor of the lung. During the preoperative investigation, a CT scan of the head revealed a sellar mass. Six months after a left lower lobectomy, the sellar lesion was removed by transsphenoidal surgery. The two tumors were evaluated by histology, immunohistochemistry and electron microscopy. Both showed identical morphologic features, those of carcinoid tumor. Immunohistochemistry revealed immunoreactivity for the endocrine markers, synaptophysin and chromogranin, as well as CD-56, serotonin, bombesin and vascular endothelial growth factor. The sellar neoplasm showed nuclear immunopositivity for thyroid transcription factor-1, supporting the diagnosis of a metastatic bronchial carcinoid tumor. In conclusion, this is the first report of a serotonin- and bombesin-immunopositive atypical bronchial carcinoid tumor metastatic to the sella. PMID:22485018

  4. Minute liver metastases from a rectal carcinoid: A case report and review

    PubMed Central

    Yamamoto, Hirofumi; Hemmi, Hideyuki; Gu, Jin-Yu; Sekimoto, Mitsugu; Doki, Yuichiro; Mori, Masaki

    2010-01-01

    We here report a 43-year-old male patient with minute liver metastases from a rectal carcinoid. Hepatic nodules were diagnosed during surgery, although they were not diagnosed by preoperative computed tomography or ultrasound examination. The rectal carcinoid was resected together with liver metastases and the patient has had no disease recurrence for 5 years following postoperative treatment of hepatic arterial infusion chemotherapy (HAIC) using 5-fluorouracil (5-FU) and oral administration of 1-hexylcarbamoyl-5-fluorouracil (HCFU). In 2003, a health check examination indicated presence of occult blood in his stool. Barium enema study revealed a rectal tumor in the lower rectum and colonoscopy showed a yellowish lesion with a size of 30 mm in diameter. Pathological examination of the biopsy specimen indicated that the rectal tumor was carcinoid. Although preoperative imaging examinations failed to detect liver metastases, 2 min nodules were found on the surface of liver during surgery. A rapid pathological examination revealed that they were metastatic tumors from the rectal carcinoid. Low anterior resection was performed for the rectal tumor and the pathological report indicated that there were 4 metastatic lymph nodes in the rectal mesentery. The patient received treatment by HAIC using 5-FU plus oral administration of HCFU and survived for 5 years. We also review world-wide current treatments and their efficacy for hepatic metastases of carcinoid tumors. PMID:21160856

  5. [Perioperative Management of Emergency Operation for a Patient with Carcinoid Syndrome].

    PubMed

    Oishi, Yuri; Kawanoue, Naoya; Minami, Eriko; Ishikawa, Tomoki; Shin, Yoshiaki; Mieda, Hideyuki; Ishii, Mizue; Iwasaki, Etsu; Fukushima, Tomihiro; Tokioka, Hiroaki

    2015-12-01

    We report a case of carcinoid syndrome requiring an emergency operation for an upper gastrointestinal perforation. A 46-year-old man had undergone left lower lobectomy for a lung carcinoid tumor seven years previously, and liver metastasis was found five years previously. He developed cutaneous flushing and watery diarrhea, and was diagnosed with carcinoid syndrome one year previously. Although he was treated with octreotid, his symptoms became worse and he was admitted to our hospital. During the hospital stay, he underwent an emergency operation for an upper gastrointestinal perforation. Before the operation, hemodynamics were unstable. Anesthesia was induced with sevoflurane and propofol, and maintained with sevoflurane and remifentanil. Only vasopressin was used for the treatment of hypotension. Landiolol was used for perioperative tachyarrythmia. During anesthesia, there was no severe hypotension or hypertension. After the operation, he was managed with intubation in the ICU. Octreotid was administered again for the carcinoid syndrome. Vasopressin was necessary for the treatment of hypotension in the ICU. After improvement of hemodynamics, extubation was performed on the 3rd ICU day and he was discharged from the ICU on the 4th ICU day. In conclusion, we were able to perform good perioperative management of carcinoid syndrome accompanied by hemodynamic instability. PMID:26790329

  6. Transoral robotic surgery for atypical carcinoid tumor of the larynx.

    PubMed

    Muderris, Togay; Bercin, Sami; Sevil, Ergun; Acar, Baran; Kiris, Muzaffer

    2013-11-01

    In recent years, transoral robotic surgery has been introduced as an efficient and a reliable method for excision of selected oral cavity, tongue base, and supraglottic tumors in otolaryngology. In this case report, a 39-year-old woman with a history of hoarseness and dysphagia for approximately 6 months is presented. The patient was diagnosed with atypical carcinoid tumor on the laryngeal aspect of the epiglottis, and excision of the tumor was performed through transoral robotic surgery using the robotic da Vinci surgical system, a 0-degree three-dimensional endoscope, 5-mm microinstruments compatible with the da Vinci robot, and a Feyh-Kastenbauer/Weinstein-O'Malley retractor. The mass was removed completely, and no complications occurred. The patient recovered without a need for tracheotomy. Findings of the 1-year clinical follow-up revealed no locoregional recurrence or distant metastasis. This case shows, once again, that transoral robotic surgery could be used safely and effectively regardless of pathologic diagnosis in the supraglottic region tumors. PMID:24220389

  7. [A case of laparoscopic surgery for a rectal carcinoid after ALTA therapy for an internal hemorrhoid].

    PubMed

    Aomatsu, Naoki; Nakamura, Masanori; Hasegawa, Tsuyoshi; Nakao, Shigetomi; Uchima, Yasutake; Aomatsu, Keiho

    2014-11-01

    We report a case of laparoscopic surgery for a rectal carcinoid after aluminum potassium and tannic acid (ALTA) therapy for an internal hemorrhoid. A 66-year-old man was admitted to our hospital because of bleeding during defecation. He was diagnosed via anoscopy with Goligher grade II internal hemorrhoids. Examination via colonoscopy revealed 2 yellowish submucosal tumors in the lower rectum that were 5mm and 10mm in diameter. A rectal carcinoid tumor was diagnosed based on histopathology. Abdominal computed tomography demonstrated no metastases to the liver or lymph nodes. First, we performed ALTA therapy for the internal hemorrhoids. Two weeks later, we performed laparoscopic-assisted low anterior resection (D2) for the rectal carcinoid. The patient was discharged without complications and has not experienced recurrence during the 2 years of follow-up care.

  8. Cryo-recanalization in a case of carcinoid tumor - An interesting case report

    PubMed Central

    Chawla, Rakesh K; Madan, Arun; Chawla, Aditya; Arora, Harsh Nandini

    2015-01-01

    The term “cryotherapy” comes from the Greek cryo (κρύο) meaning cold, and therapy (θεραπεία) meaning cure. Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. Carcinoid tumors of the lung are a fascinating but uncommon group of pulmonary neoplasms. In the past, these tumors were grouped with benign or less aggressive malignant pulmonary tumors, namely bronchial adenomas. Recent studies have revealed that carcinoid lung tumors are the most indolent form of a spectrum of bronchopulmonary neuroendocrine tumors that, at its extreme, include small cell carcinoma of the lung as its most malignant member. They commonly present as endobronchial obstructions, and if complete, can be life-threatening and require immediate intervention.[1] Recently, we have treated a patient of carcinoid tumor of lung who was managed with cryo-recanalization with excellent response. PMID:26628773

  9. [A case of laparoscopic surgery for a rectal carcinoid after ALTA therapy for an internal hemorrhoid].

    PubMed

    Aomatsu, Naoki; Nakamura, Masanori; Hasegawa, Tsuyoshi; Nakao, Shigetomi; Uchima, Yasutake; Aomatsu, Keiho

    2014-11-01

    We report a case of laparoscopic surgery for a rectal carcinoid after aluminum potassium and tannic acid (ALTA) therapy for an internal hemorrhoid. A 66-year-old man was admitted to our hospital because of bleeding during defecation. He was diagnosed via anoscopy with Goligher grade II internal hemorrhoids. Examination via colonoscopy revealed 2 yellowish submucosal tumors in the lower rectum that were 5mm and 10mm in diameter. A rectal carcinoid tumor was diagnosed based on histopathology. Abdominal computed tomography demonstrated no metastases to the liver or lymph nodes. First, we performed ALTA therapy for the internal hemorrhoids. Two weeks later, we performed laparoscopic-assisted low anterior resection (D2) for the rectal carcinoid. The patient was discharged without complications and has not experienced recurrence during the 2 years of follow-up care. PMID:25731340

  10. Primary renal carcinoid tumor: case report and review of the literature

    PubMed Central

    Li, Bin; Cui, Tongyue; Ban, Ziqin; Luo, Lei; Sun, Lijiang

    2016-01-01

    Objective The aim of this case report is to discuss the clinicopathological features of a patient with a primary renal carcinoid tumor. Methods We report on the clinical and pathological information of one case of a patient with a primary renal carcinoid tumor as well as review relative literature. Results The patient was diagnosed with a renal tumor when she received physical examination, and exhibited no positive symptoms. The diameter of tumor was 5 cm, the cross surface of the tumor was light yellow and firm, and the central part was soft with hemorrhage and necrosis. Immunohistochemical staining revealed strong and diffuse staining with synaptophysin, chromogranin A, and neuron-specific enolase. Conclusion A primary renal carcinoid tumor is extremely rare. Surgical resection is a preferred therapeutic method. PMID:26966374

  11. Current concepts in diagnosis and perioperative management of carcinoid heart disease.

    PubMed

    Castillo, Javier G; Silvay, George; Solís, Jorge

    2013-09-01

    Carcinoid tumors are neuroendocrine tumors with a very unpredictable clinical behavior. In the setting of hepatic metastases, the tumor's release of bioactive substances into the systemic circulation results in carcinoid syndrome: a constellation of symptoms among which cutaneous flushing, gastrointestinal hypermotility, and cardiac involvement are the most prominent. Cardiac manifestations, also known as carcinoid heart disease, are secondary to a severe fibrotic reaction which frequently involves the right-sided valves and may extend towards the subvalvular apparatus leading to valve thickening and retraction. Left-sided involvement is rare and mostly observed in the presence of an interatrial shunt, endobronchial tumor localization, and high tumor activity. Echocardiographic techniques often reveal noncoaptation of the valves, which are fixed in a semiopen position. In patients with advanced lesions and severe valvular dysfunction, surgery is currently the only definitive treatment to potentially improve quality of life and provide survival benefit. Although cardiac surgery has been traditionally reserved for those patients with symptomatic right ventricular failure, a significant trend towards improved surgical outcomes has triggered a more liberal referral for valve replacement. Carcinoid heart disease poses two distinct challenges for the anesthesiologist: carcinoid crisis and low cardiac output syndrome secondary to right ventricular failure. Carcinoid crisis, characterized by flushing, hypotension, and bronchospasm, may be precipitated by catecholamines and histamine releasing drugs used routinely in patients undergoing valve surgery. Although a broader utilization of octreotide have significantly simplified the anesthetic and perioperative management of these patients, a very balanced anesthetic technique is required to identify and manage low cardiac output syndrome.

  12. Gastric carcinoids and therapeutic options. Case report and review of the literature.

    PubMed

    Dobru, Daniela; Boeriu, Alina; Mocan, Simona; Pascarenco, Ofelia; Boeriu, Cristian; Molnar, Calin

    2013-03-01

    Neuroendocrine tumors (carcinoids) are tumors originating from neuroendocrine cells. The distinction between different types of gastric carcinoids is important for their management. We present the case of a 38-year old woman with type 1 gastric neuroendocrine tumors (NETs) associated with autoimmune atrophic gastritis. The management of these tumors has not been yet codified and different therapeutic strategies have been suggested. A proper evaluation before therapy is indicated in order to rule out both the malignant transformation as well as the presence of synchronous lesions, such as dysplasia or gastric adenocarcinoma. We describe our diagnostic and therapeutic strategies with references to previously published reports. PMID:23539397

  13. Cushing's like syndrome in typical bronchial carcinoid a case report and review of the literature.

    PubMed

    Pedicelli, Ilaria; Patriciello, Giuseppina; Scala, Giovanni; Sorrentino, Antonietta; Gravino, Gennaro; Patriciello, Pasquale; Zeppa, Pio; Di Crescenzo, Vincenzo; Vatrella, Alessandro

    2016-01-01

    Cushing's syndrome occurred in 1-5% of cases of bronchial carcinoids. In this paper we describe a case of typical bronchial carcinoid in a nonsmoker young male with clinical manifestations mimicking a Cushing's syndrome. The patient performed chest radiograph and computed tomography. Fiberoptic bronchoscopy revealed the presence of an endobronchial mass occluding the bronchus intermedius. A rigid bronchoscopy was necessary for the conclusive diagnosis and for partial resection of the intraluminal tumor. Despite of the presence of Cushingoid features, the normal blood levels of ACTH and cortisol excluded the coexistence of a Cushing's syndrome. PMID:26923475

  14. Photodynamic therapy for bronchial carcinoid tumours: complete response over a 10-year follow-up.

    PubMed

    Moghissi, Keyvan; Dixon, Kate; Gibbins, Sally

    2013-06-01

    A 63-year old woman diagnosed in September 2001 with a typical bronchial carcinoid of the left upper lobe bronchus extending into the left main stem bronchus is presented. The patient was unsuitable for standard surgical treatment, and the topography was not amenable for a parenchyma-saving bronchoplastic procedure. Two cycles of bronchoscopic photodynamic therapy (PDT) were undertaken at 6 monthly intervals. The patient has now been followed up regularly for over 10 years without signs of recurrence bronchoscopically or radiologically. To our knowledge, this is the first case of a carcinoid tumour treated solely by PDT. PMID:23284100

  15. Cushing's like syndrome in typical bronchial carcinoid a case report and review of the literature.

    PubMed

    Pedicelli, Ilaria; Patriciello, Giuseppina; Scala, Giovanni; Sorrentino, Antonietta; Gravino, Gennaro; Patriciello, Pasquale; Zeppa, Pio; Di Crescenzo, Vincenzo; Vatrella, Alessandro

    2016-01-01

    Cushing's syndrome occurred in 1-5% of cases of bronchial carcinoids. In this paper we describe a case of typical bronchial carcinoid in a nonsmoker young male with clinical manifestations mimicking a Cushing's syndrome. The patient performed chest radiograph and computed tomography. Fiberoptic bronchoscopy revealed the presence of an endobronchial mass occluding the bronchus intermedius. A rigid bronchoscopy was necessary for the conclusive diagnosis and for partial resection of the intraluminal tumor. Despite of the presence of Cushingoid features, the normal blood levels of ACTH and cortisol excluded the coexistence of a Cushing's syndrome.

  16. Carcinoid tumor arising in a mature cystic teratoma: A case report

    PubMed Central

    TOSUNER, ZEYNEP; SÖNMEZ, FATMA CAVİDE; ARICI, DİLEK SEMA; DANSUK, RAMAZAN

    2015-01-01

    Mature cystic teratomas are common benign tumors of the ovary. The most common form of malignant transformation is squamous cell carcinoma, however, malignant transformation is rarely observed and cases are usually asymptomatic. Carcinoid tumors are rare tumors of the neuroendocrine system. A number of the carcinoids result in clinical syndromes due to the secretion of vasoactive substances produced by the tumor. A 75-year-old woman suffering from groin pain was admitted to the Faculty of Medicine at Bezmialem Vakıf University (Istanbul, Turkey). An adnexal mass was detected during the physical examination. Magnetic resonance imaging scans exhibited an 8×7-cm mass in the right ovary. Surgical excision of the mass was performed and histopathological examination revealed a mature cystic teratoma with three germ layers. An area consisting of nests and trabeculae was evident in the cyst wall. The pathological diagnosis was of an insular and trabecular variant of carcinoid tumor arising in a mature cystic teratoma. The patient did not present with carcinoid syndrome, and no recurrence was observed after 11 months of follow-up examinations. PMID:26137048

  17. Pure bronchoplastic resections of the bronchus without pulmonary resection for endobronchial carcinoid tumours†

    PubMed Central

    Nowak, Kai; Karenovics, Wolfram; Nicholson, Andrew G.; Jordan, Simon; Dusmet, Michael

    2013-01-01

    OBJECTIVES Bronchopulmonary carcinoid tumours are relatively uncommon primary lung neoplasms. A small proportion of these lesions are predominantly endobronchial and do not extend beyond the bronchial wall. Endoscopic resection can be performed, but carries around a one in three risk of local recurrence and, therefore, mandates long-term surveillance. An alternative is complete surgical resection via bronchoplastic resection. We present our experience of surgical resection in patients with endobronchial carcinoids. METHODS From 2000 to 2010, 13 patients (age 45 ± 16 years, 10 males) underwent pure bronchoplastic resection, including systematic nodal dissection, for endobronchial carcinoid tumours, without the resection of lung parenchyma. RESULTS There was no significant operative morbidity or mortality. This is a retrospective review of a consecutive case series. The last follow-up for all patients was obtained in 2011. The mean maximum tumour size was 18 ± 8 mm. No lymph node invasion was observed. The median follow-up was 6.3 ± 3.3 years, with no regional recurrence. In 1 case, a tumourlet was identified at 5 years in the contralateral airway and viewed as a metachronous new lesion. CONCLUSIONS Bronchial sleeve resection is a safe procedure for suitably located endobronchial carcinoid tumours. Endoscopic resection should be reserved for patients who decline, or are unfit, for surgery. PMID:23628650

  18. Management of occult adrenocorticotropin-secreting bronchial carcinoids: limits of endocrine testing and imaging techniques.

    PubMed

    Loli, P; Vignati, F; Grossrubatscher, E; Dalino, P; Possa, M; Zurleni, F; Lomuscio, G; Rossetti, O; Ravini, M; Vanzulli, A; Bacchetta, C; Galli, C; Valente, D

    2003-03-01

    The differential diagnosis and the identification of the source of ACTH in occult ectopic Cushing's syndrome due to a bronchial carcinoid still represents a challenge for the endocrinologist. We report our experience in six patients with occult bronchial carcinoid in whom extensive hormonal, imaging, and scintigraphic evaluation was performed. All patients presented with hypercortisolism associated with high plasma ACTH values. The CRH test and high dose dexamethasone suppression test suggested an ectopic source of ACTH in three of six patients. During bilateral inferior petrosal sinus sampling, none of the patients showed a central to peripheral ACTH gradient. At the time of diagnosis, none of the patients had radiological evidence of the ectopic source of ACTH, whereas pentetreotide scintigraphy identified the lesion in two of four patients. Finally, a chest computed tomography scan revealed the presence of a bronchial lesion in all patients, and pentetreotide scintigraphy identified four of six lesions. In all patients a bronchial carcinoid was found and removed. In one patient with scintigraphic evidence of residual disease after two operations, radioguided surgery, using a hand-held gamma probe after iv administration of radiolabeled pentetreotide, was performed; this allowed detection and removal of residual multiple mediastinal lymph node metastases. In conclusion, our data show that there is not a single endocrine test or imaging procedure accurate enough to diagnose and localize occult ectopic ACTH-secreting bronchial carcinoids. Radioguided surgery appears to be promising in the presence of multiple tumor foci and previous incomplete removal of the tumor. PMID:12629081

  19. Acromegaly due to a Macroinvasive Plurihormonal Pituitary Adenoma and a Rectal Carcinoid Tumor

    PubMed Central

    Chin, Sang Ouk; Hwang, Jin-Kyung; Rhee, Sang Youl; Chon, Suk; Oh, Seungjoon; Lee, Misu; Pellegata, Natalia S.

    2015-01-01

    A macroinvasive pituitary adenoma with plurihormonality usually causes acromegaly and hyperprolactinemia, and also accompanies with neurologic symptoms such as visual disturbances. However, its concurrent presentation with a rectal carcinoid tumor is rarely observed. This study reports the history, biochemical, colonoscopic and immunohistochemical results of a 48-year-old female with acromegaly and hyperprolactinemia. Despite the large size and invasive nature of the pituitary adenoma to adjacent anatomical structures, she did not complain of any neurologic symptoms such as visual disturbance or headache. Immunohistochemical staining of the surgical specimen from the pituitary adenoma revealed that the tumor cells were positive for growth hormone (GH), prolactin (PRL), and thyroid stimulating hormone (TSH). Staining for pituitary-specific transcription factor-1 (Pit-1) was shown to be strongly positive, which could have been possibly contributing to the plurihormonality of this adenoma. Colonoscopy found a rectal polyp that was identified to be a carcinoid tumor using immunohistochemical staining. A macroinvasive pituitary adenoma with concomitant rectal carcinoid tumor was secreting GH, PRL, and TSH, which were believed to be in association with over-expression of Pit-1. This is the first case report of double primary tumors comprising a plurihormonal pituitary macroadenoma and rectal carcinoid tumor. PMID:25559714

  20. Management of occult adrenocorticotropin-secreting bronchial carcinoids: limits of endocrine testing and imaging techniques.

    PubMed

    Loli, P; Vignati, F; Grossrubatscher, E; Dalino, P; Possa, M; Zurleni, F; Lomuscio, G; Rossetti, O; Ravini, M; Vanzulli, A; Bacchetta, C; Galli, C; Valente, D

    2003-03-01

    The differential diagnosis and the identification of the source of ACTH in occult ectopic Cushing's syndrome due to a bronchial carcinoid still represents a challenge for the endocrinologist. We report our experience in six patients with occult bronchial carcinoid in whom extensive hormonal, imaging, and scintigraphic evaluation was performed. All patients presented with hypercortisolism associated with high plasma ACTH values. The CRH test and high dose dexamethasone suppression test suggested an ectopic source of ACTH in three of six patients. During bilateral inferior petrosal sinus sampling, none of the patients showed a central to peripheral ACTH gradient. At the time of diagnosis, none of the patients had radiological evidence of the ectopic source of ACTH, whereas pentetreotide scintigraphy identified the lesion in two of four patients. Finally, a chest computed tomography scan revealed the presence of a bronchial lesion in all patients, and pentetreotide scintigraphy identified four of six lesions. In all patients a bronchial carcinoid was found and removed. In one patient with scintigraphic evidence of residual disease after two operations, radioguided surgery, using a hand-held gamma probe after iv administration of radiolabeled pentetreotide, was performed; this allowed detection and removal of residual multiple mediastinal lymph node metastases. In conclusion, our data show that there is not a single endocrine test or imaging procedure accurate enough to diagnose and localize occult ectopic ACTH-secreting bronchial carcinoids. Radioguided surgery appears to be promising in the presence of multiple tumor foci and previous incomplete removal of the tumor.

  1. Goblet cells carcinoid with mucinous adenocarcinoma of the vermiform appendix: a step towards the unitary intestinal stem cell theory?

    PubMed

    Gravante, G; Yahia, S; Gopalakrishnan, K; Mathew, G

    2014-06-01

    Associations of various histotypes in appendiceal neoplasms may help elucidate the histogenesis of such uncommon tumors. We present the fourth published case of Goblet Cell Carcinoid (GCC) associated with mucinous adenocarcinoma of the appendix. This association has been described only for GCC and not for classic appendix carcinoids which are thought to originate from neuroendocrine-committed cells. The GCC-mucinous association adds more towards the theory of a pluripotent intestinal stem cell with amphicrine possibilities of differentiation.

  2. Incidentally discovered goblet cell carcinoid clinically presenting as acute intestinal obstruction: a case report with review of literature.

    PubMed

    Afroz, Nishat; Shamim, Nida; Sofi, Lateef Ahmed; Rizvi, Syed Amjad Ali

    2014-01-01

    Goblet cell carcinoid (GCC) is a rare variant of carcinoid tumor that exclusively involves the appendix. It usually occurs in 5th-6th decade with the most common clinical presentation being acute appendicitis. The natural history of this tumor is intermediate between carcinoids and adenocarcinomas. We here report a case of GCC diagnosed incidentally in a patient presenting with acute intestinal obstruction. Ultrasonographic examination supported the clinical diagnosis of acute intestinal obstruction, following which the patient underwent laparotomy and resection of ileum along with appendix was done. On gross pathological examination, a nodular growth was present on the tip and body of appendix that was yellow in color with a semi-solid to mucoid consistency on cut section. On microscopy, lakes of mucin with few acinar structures floating in them were seen. The submucosa as well as serosa were infiltrated by clusters of goblet cells and well-formed acini, with little atypia. Glands and nests were positive for periodic acid Schiff and immunohistochemistry showed focal chromogranin positivity in glandular structures, thereby confirming the diagnosis of GCC. Although the prognosis of GCC is better than adenocarcinomas, it is one of the carcinoids having a poorer outcome when compared with other variants of carcinoid tumor. Therefore, it is important to rule out other differential diagnoses of goblet cell carcinoid, the most important being mucinous adenocarcinomas. PMID:24739849

  3. FAIM2, as a novel diagnostic maker and a potential therapeutic target for small-cell lung cancer and atypical carcinoid

    PubMed Central

    Kang, Hio Chung; Kim, Jong In; Chang, Hee Kyung; Woodard, Gavitt; Choi, Young Sik; Ku, Ja-Lok; Jablons, David M.; Kim, Il-Jin

    2016-01-01

    Lung neuroendocrine (NE) tumors are a heterogeneous group of tumors arising from neuroendocrine cells that includes typical carcinoid, atypical carcinoid, small cell lung cancer (SCLC), and large cell NE cancer. The subtyping of NE tumors is based on the number of mitoses per high powered field and the presences of necrosis. However, the best diagnostic criteria to differentiate various subtypes of lung NE tumors remains controversial and few diagnostic markers distinguish typical and atypical carcinoid. In this study, we show that FAIM2, an inhibitory molecule in the Fas-apoptosis pathway, is significantly overexpressed in SCLC compared to non-small cell lung cancer. In addition, FAIM2 expression is significantly higher in atypical carcinoid than typical carcinoid. As atypical carcinoid has been shown to have worse clinical outcomes than typical carcinoid, our data suggests that FAIM2 may be a useful diagnostic marker for atypical carcinoid. Knockdown of FAIM2 expression increases Fas-induced apoptotic cell death in SCLC cells. Etoposide treatment combined with FAIM2 inhibition also shows modest but significant reduction of viable SCLC cells. Taken together, our results suggest that FAIM2 is a potential NE tumor marker with higher expression in atypical carcinoid and SCLC, and could be a new therapeutic target for SCLC. PMID:27677402

  4. Carcinoid Heart Disease: From Pathophysiology to Treatment--'Something in the Way It Moves'.

    PubMed

    Grozinsky-Glasberg, Simona; Grossman, Ashley B; Gross, David J

    2015-01-01

    Carcinoid heart disease (CHD) is a rare cardiac manifestation occurring in patients with advanced neuroendocrine tumours and the carcinoid syndrome, usually involving the right-sided heart valves and eventually leading to right heart failure. The pathophysiology of CHD is still obscure and believed to be multifactorial, as a variety of vasoactive substances secreted by the tumour appear to be involved. The management of patients with CHD is complex, as both the systemic malignant disease and the heart involvement have to be addressed. Timely diagnosis and early surgical treatment in appropriately selected patients are of outmost importance, as CHD is associated with increased morbidity and mortality. Valve replacement surgery alleviates right heart failure and may also contribute to improved survival. In the present study we have comprehensively reviewed the existing literature to date, mainly focusing on the pathophysiology of CHD. Other aspects of CHD (such as the clinical presentation, diagnostic tools and therapeutic approach) are addressed in brief.

  5. Sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery: A case report

    PubMed Central

    Kinoshita, Takahiro; Oshiro, Takashi; Urita, Tasuku; Yoshida, Yutaka; Ooshiro, Mitsuru; Okazumi, Shinichi; Katoh, Ryoji; Sasai, Daisuke; Hiruta, Nobuyuki

    2010-01-01

    We report a case of sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery. A 38-year old asymptomatic woman was referred to our hospital for evaluation of a submucosal tumor of the stomach. Endoscopic examination showed a solitary submucosal tumor without ulceration or central depression on the posterior wall of the antrum and biopsy specimens were not sufficient to determine the diagnosis. Endoscopic ultrasound revealed a tumor nearly 2 cm in diameter arising from the muscle layer and a computed tomography scan showed the tumor enhanced in the arterial phase. Laparoscopic wedge resection was performed for definitive diagnosis. Pathologically, the tumor was shown to be gastric carcinoid infiltrating the muscle layer which indicated the probability of lymph node metastasis. Serum gastrin levels were normal. As a radical treatment, laparoscopy-assisted distal gastrectomy with regional lymphadenectomy was performed 3 wk after the initial surgery. Finally, pathological examination revealed no lymph node metastasis. PMID:21160902

  6. Acute appendicitis with a neuroendocrine tumor G1 (carcinoid): pitfalls of conservative treatment.

    PubMed

    Watanabe, Hiroyuki A; Fujimoto, Taketoshi; Kato, Yo; Sasaki, Mayumi; Ikusue, Toshikazu

    2016-08-01

    A man in his early thirties presented to our clinic with right lower abdominal pain. Computed tomography (CT) and ultrasonography (US) revealed a swollen appendix and an appendicolith. Abscess formation was not observed but ongoing appendiceal rupture was not ruled out. Three months after successful conservative therapy, the lumen of the apical portion was kept dilated and laparoscopic interval appendectomy was performed. No tumorous findings were observed macroscopically. However, histology revealed many tiny nests infiltrating the submucosa, muscular layer, and subserosa at the root of the appendix. An appendiceal neuroendocrine tumor G1 (NET G1; carcinoid) was diagnosed immunohistologically. Neither CT nor US visualized the tumor because of its non-tumor-forming but infiltrative growth. In conclusion, after successful conservative treatment, interval appendectomy should be considered to uncover a possible appendiceal NET G1 (carcinoid), particularly when dilatation of the distal lumen is kept under observation. PMID:27311320

  7. Carcinoid tumor of the middle ear: a case report and review of literature

    PubMed Central

    Liu, Guo; Chen, Fei; Li, Jin-Nan; Liu, Shi-Xi

    2014-01-01

    Carcinoid tumors of the middle ear are very rare. Here we describe a 37-year-old man with multiple recurrent carcinoid tumor of the right middle ear. The CT demonstrated the recurrent mass that filled the tympanum and mastoid with osteolytic invasion, and the tumor was removed by surgery. The pathological findings showed the tumor cells, without necrosis and mitotic activity, had round, oval, or slightly irregular nuclei and finely-dispersed chromatin, arranged in cords, nests, and glandular structures. They were strongly positive for synaptophysin and CD56, but were negative for S-100 and chromogranin A. Ki-67 proliferation activity was low (<2%). With a review of the literature, the clinical, pathological characteristics and treatment modalities of this rare tumor are discussed. PMID:25400805

  8. A case of diffused malignant pleural mesothelioma forming small multiple disseminations with intraoperatively suspicious carcinoid tumors.

    PubMed

    Suemitsu, Ryuichi; Takeo, Sadanori; Hamatake, Motoharu; Furuya, Kiyomi; Uesugi, Noriko

    2011-01-01

    A 65-year-old male, having symptoms suggestive of pulmonary malignant tumor, underwent video-assisted thoracic surgery (VATS). Surgery revealed a solid tumor originating from the thoracic wall, with many small solid tumors in the thoracic wall and diaphragm near the tumor. The intraoperative observation of a frozen section typed the tumor as carcinoid; however, hematoxylin-eosin staining and immunohistological findings provided the definitive diagnosis of diffused, malignant pleural mesothelioma (MPM).

  9. Clinicopathologic and DNA cytometric analysis of carcinoid tumors of the thymus.

    PubMed

    Goto, K; Kodama, T; Matsuno, Y; Yokose, T; Asamura, H; Kamiya, N; Shimosato, Y

    2001-10-01

    Twelve cases of carcinoid tumors of the thymus were reviewed in terms of clinicopathologic, histochemical, and immunohistochemical features and DNA ploidy patterns. The collective consisted of nine male and three female patients, aged 34 to 74 years, of whom five (42%) had symptoms. Eleven patients underwent surgical resection, and one with systemic metastases was autopsied. In the 11 resected patients, tumors had invaded surrounding structures in four cases, and mediastinal lymph node metastases were detected in six. Recurrence occurred in two of the resected patients (18%), and the 5-year survival rate was 82%. Histologically, all tumors showed an organoid growth pattern with delicate fibrovascular stroma. In addition, three tumors had unusual morphologic features such as combined features of carcinoid tumor and thymoma and solid growth pattern with occasional large tumor cells. Mitotic counts ranged from 1 to 14 per 10 high-power fields with a mean count of 4.9. Central necrosis within solid nests was observed in nine tumors. Classification of this series using the WHO histologic classification system resulted in categorization of all 12 tumors as atypical carcinoids. All tumors were positive for Grimelius staining and for cytokeratin. Immunohistochemical staining documented the presence of moderately to strongly positive neuroendocrine markers such as neuron-specific enolase, chromogranin A, synaptophysin, and neural cell adhesion molecule. No correlation between proliferative activity based on the Ki67 labeling index and prognosis or lymph node metastasis was found. Concerning DNA ploidy patterns, only one tumor with multiple lymph node metastases was considered to be aneuploid. In conclusion, although all of our cases were histologically classified as atypical carcinoid tumors of the thymus, most were diploid, and the patients enjoyed a relatively good prognosis.

  10. A case of bronchial carcinoid: diagnosis and follow-up with 111In-DTPA-octreotide.

    PubMed

    Orsolon, P; Bagni, B; Basadonna, P; Geatti, O; Talmassons, G; Guerra, U P

    1995-12-01

    Scintigraphy with radiolabelled analogue of somatostatin is highly sensitive in detecting carcinoid tumors especially if performed with Single Photon Computed Tomography (SPECT). In this report we describe our experience with 111In-DTPA-Octreotide in a female patient affected by a small asymptomatic intrabronchial carcinoid demonstrated by CT scan and bronchial endoscopy performed after recurrent left pneumonias. Planar views and SPECT images, using 111In-DTPA-Octreotide, were collected before and four hours after the first endoscopic laser resection. All groups of SPECT images were positive in the left parahilar region but at a different degree. Scans performed after resection showed a low degree of uptake which was considered to be probably secondary to local swelling; CT scan was negative. Follow up endoscopic biopsy repeated at six months, showed a relapse always in the same site; CT scan of the thorax was again negative. 111In-DTPA-Octreotide images obtained at twelve months were positive always in the left parahilar region, CT scan was negative but another biopsy was not possible. Therefore it was suspected a relapse of the carcinoid which was probably growing only through the bronchial wall without spreading towards the bronchial lumen and/or the lung parenchima. In this occasion, it was also thought that images collected four hours after resection could be positive not only for swelling but for a relapse as well. In every scintigraphic session, SPECT images presented higher quality than planar. This case suggests that 111In-DTPA-Octreotide SPECT is a non-invasive diagnostic technique which could be applied as a follow-up tool especially to patients with no-secreting carcinoid neoplasm and/or with negative or doubtful endoscopic and radiological investigations.

  11. Roentgenologic diagnosis of primary corticotropin-producing carcinoid tumors of the mediastinum

    SciTech Connect

    Brown, L.R.; Aughenbaugh, G.L.; Wick, M.R.; Baker, B.A.; Salassa, R.M.

    1982-01-01

    A study was undertaken of five patients with Cushing syndrome due to adrenocorticotropin (ACTH) production by thymic carcinoid tumor (primary mediastinal Apudomas), including two recent patients examined by computed tomography (CT) of the chest. Plain roentgenography of the chest initially failed to detect tumor in four of the five patients, while CT of the chest yielded definitive diagnostic information in both patients in whom it was employed. For one of these patients, a mediastinal tumor could be seen retrospectively on plain roentgenograms of the chest, although it had been missed on the first examination. One of the tumors appeared to be partially calcified on CT scan, a finding not previously reported. Blastic osseous metastasis, which is common when malignant carcinoid tumors spread to bone, was seen in one patient. Our data suggest that in patients with suspected ectopic ACTH production, CT scanning of the mediastinum should be performed early in order to avoid delay in diagnosis of an ACTH-secreting carcinoid tumor of the mediastinum.

  12. Mature Ovarian Teratoma with Carcinoid Tumor in a 28-Year-Old Patient

    PubMed Central

    Petousis, Stamatios; Kalogiannidis, Ioannis; Margioula-Siarkou, Chrysoula; Traianos, Alexandros; Miliaras, Dimosthenis; Kamparoudis, Apostolos; Mamopoulos, Apostolos; Rousso, David

    2013-01-01

    Introduction. Coexistence of carcinoid tumor inside a mature cystic teratoma is an extremely rare phenomenon, especially in young women. We present the case of a 28-year-old woman diagnosed with a right ovarian carcinoid and treated uneventfully with conservative surgical approach. Case Report. A 28-year-old woman, gravid 0, parity 0, presented to our department for her annual gynecological examination and Pap smear test. During her examination, a mobile cystic mass was detected in the right lower abdomen. Ultrasound indicated a right ovarian mass 10.5 × 6.3 cm, confirmed by CT scan. Further investigation revealed AFP levels (1539 ng/mL). The ovarian mass was excised by laparoscopy, leaving intact the remaining right ovary. Frozen sections showed a mature cystic teratoma. However, paraffin sections revealed the presence of a small carcinoid within the teratoma's gastric-type mucosa. The patient was set to a close followup. Nine months postoperatively, ultrasound pelvis imaging and CT scan of the abdomen as well as serum tumor markers have shown no evidence of recurrence disease. Conclusion. Despite the weak evidence, fertility spare surgical approach for women wanting to preserve their genital tract might be a reasonable option. PMID:23984130

  13. [Multifocal gastric carcinoid associated with chronic type A atrophic gastritis. Analysis of 2 clinical cases].

    PubMed

    Moneghini, D; Fontana, M G; Villanacci, V; Salerni, B

    2001-01-01

    Gastric carcinoid is a rare disease, representing less than 1% of gastric tumours and 11-41% of all gastrointestinal carcinoids. The recent Solcia's classification distinguishes three subtypes of these neoplasms, which show specific clinical and pathological features. Type one arises in patients with chronic atrophic gastritis (CGA), achlorhydria, hypergastrinemia and consequent enterochromaffin-like cell hyperplasia and dysplasia. Type two is related to Zollinger Ellison syndrome and type three represents the sporadic kind. We report two cases of multifocal gastric carcinoid associated to CGA, one of them with pernicious anemia. Both patients had aspecific abdominal symptoms; the diagnosis was suspected by upper endoscopy and confirmed by histological examination. Patients were submitted to total gastrectomy. They are still alive six years after surgery, without signs or symptoms of recurrences. Treatment of these tumours is controversial, because of their uncertain biological and clinical behaviour. Some Authors propose a conservative strategy (only endoscopic surveillance or removal); others stress importance of surgery (antrectomy or gastric resection). We discuss and underline the role of surgical therapy and the relevance of radical approach.

  14. Carcinoid crisis induced by receptor radionuclide therapy with 90Y-DOTATOC in a case of liver metastases from bronchial neuroendocrine tumor (atypical carcinoid).

    PubMed

    Davì, M V; Bodei, L; Francia, G; Bartolomei, M; Oliani, C; Scilanga, L; Reghellin, D; Falconi, M; Paganelli, G; Lo Cascio, V; Ferdeghini, M

    2006-06-01

    SS receptors are overexpressed in many tumors, mainly of neuroendocrine origin, thus enabling the treatment with SS analogs. The clinical experience of receptor radionuclide therapy with the new analog [90Y-DOTA0-Tyr3 ]-octreotide [90Y-DOTATOC] has been developed over the last decade and is gaining a pivotal role in the therapeutic workout of these tumors. It is well known that some procedures performed in diagnostic and therapeutic management of endocrine tumors, such as agobiopsy and hepatic chemoembolization, can be associated with the occurrence of symptoms related to the release of vasoactive amines and/or hormonal peptides from tumor cell lysis. This is the first report of a severe carcinoid crisis developed after receptor radionuclide therapy with 90Y-DOTATOC administered in a patient affected by liver metastases from bronchial neuroendocrine tumor (atypical carcinoid). Despite protection with H1 receptor antagonists, octreotide and corticosteroids, few days after the therapy the patient complained of persistent flushing of the face and upper trunk, severe labial and periocular oedema, diarrhoea and loss of appetite. These symptoms increased and required new hospitalisation. The patient received iv infusion of octreotide associated with H1 and H2 receptor antagonists and corticosteroid therapy, which induced symptom remission within few days. The case here reported confirms that radionuclide therapy is highly effective in determining early rupture of metastatic tissue and also suggests that pre-medication should be implemented before the radiopeptide administration associated with a close monitoring of the patient in the following days.

  15. Two cases of endobronchial carcinoid masked by superimposed aspergillosis: a review of the literature of primary lung cancers associated with Aspergillus.

    PubMed

    Nilsson, John Robert; Restrepo, Carlos S; Jagirdar, Jaishree

    2013-02-01

    We describe 2 cases of endobronchial pulmonary carcinoid tumor with superimposed Aspergillus colonization. The Aspergillus hyphae were associated with fibrin, ulcer debris, and granulomatous inflammation in part masking the carcinoid tumor. Presence of necrotic debris made diagnosis on biopsy difficult, and atypical carcinoid could not be ruled out. The association of carcinoid tumor with aspergillosis is rare and has been reported in 4 other cases thus far. A review of the literature reveals at least 35 cases of lung carcinoma with coexisting Aspergillus upon presentation. Most of these carcinomas are either cavitary squamous cell or adenocarcinomas harboring an aspergilloma. The other carcinomas are associated with bronchial obstruction as in carcinoids or are a minor component of a preexisting cavity raising the possibility of "scar carcinoma." As in aspergillomas not associated with carcinoma, upper lobe involvement predominates. Diagnosis can be challenging with delayed discovery of underlying neoplasm leading to suboptimal treatment. PMID:22079170

  16. Detection of somatostatin receptors in surgical and percutaneous needle biopsy samples of carcinoids and islet cell carcinomas.

    PubMed

    Reubi, J C; Kvols, L K; Waser, B; Nagorney, D M; Heitz, P U; Charboneau, J W; Reading, C C; Moertel, C

    1990-09-15

    Somatostatin (SS) receptor status was investigated in the tumor tissues from 62 patients with carcinoid tumors and 15 patients with islet cell carcinomas using receptor autoradiography techniques with two different iodinated somatostatin analogues as radioligands, a [Leu8, DTrp22, Tyr25]somatostatin-28 and a somatostatin octapeptide, Tyr3-octreotide. The carcinoid tumors were either primaries (n = 32) or metastases (n = 43), sampled as surgical specimens or as small needle liver biopsies. Fifty-four of 62 carcinoid patients had SS receptor-positive tumors (87%). All 15 islet cell carcinoma patients had positive tumors (4 primaries, 11 metastases), i.e., 3 vipomas, 3 insulinomas, 2 glucagonomas, 1 gastrinoma, 2 polyfunctional tumors, and 4 nonfunctioning tumors. Saturation and competition experiments on tissue sections revealed saturable, high affinity binding sites pharmacologically specific for bioactive SS analogues. In a majority of the tumors, the receptors were densely distributed and were always homogeneously found in the whole tumor. All except two tumors were labeled with both radioligands. Multiple liver metastases (n = 16) from three different patients were all shown to contain a comparable amount of receptors. SS receptors could be demonstrated even in very small tissue samples of liver metastases obtained by percutaneous liver biopsies (mean weight, 6.8 mg). The majority of the eight SS receptor-negative carcinoids were mainly bronchial carcinoids (n = 5), usually poorly differentiated. On the contrary, SS receptor-positive cases were never found to be anaplastic. All tumors except one from patients pretreated with octreotide (3 days to 3.8 years) were SS receptor positive. In the majority of carcinoids or islet cell carcinomas, the SS receptor status correlated with the in vivo biochemical response (hormone inhibition) to octreotide. These data demonstrate (a) the high prevalence of SS receptors in the primary tumors of both carcinoids and islet cell

  17. Endoscopic mucosal resection with circumferential incision for treatment of rectal carcinoid tumours

    PubMed Central

    2014-01-01

    Background Endoscopic mucosal resection (EMR) is simple and quick and has low complication rates. However, the disadvantage of local recurrence or remnant rate limits the use of this technique. We aimed to analyse the outcomes of conventional EMR and EMR with circumferential incision (CIEMR), a simplified modification of EMR, in the endoscopic treatment of rectal carcinoid tumours. Methods A total of 59 consecutive patients with rectal carcinoid tumours without regional lymph node enlargement confirmed by endoscopic ultrasonography were included in the study. These patients underwent endoscopic treatment from January 2009 to September 2011 and were randomly designated into CIEMR (n = 31) or EMR group (n = 28). En bloc resection rate, pathological complete resection rate, procedure time, complications and follow-up outcomes were analysed. Results The en bloc resection rate was not significantly different between the CIEMR and EMR groups (100% versus 96.55%, P > 0.05). The pathological complete resection rate was higher in the CIEMR group than in the EMR group (96.7% versus 82.14%, P < 0.05). The overall complication rate, delayed bleeding and procedure time were not significantly different between the two groups. No recurrence was observed in either the EMR or CIEMR group. Conclusions CIEMR optimises the procedure of EMR and simplifies the technique of endoscopic submucosal dissection; thus, it has a better histologically complete resection rate and more acceptable complication rate than EMR. Thus, CIEMR may be preferable to conventional EMR for resection of rectal carcinoid tumours less than 15 mm. PMID:24472342

  18. A Rare Combination of Ovarian and Uterine Leiomyomas with Goblet Cell Carcinoid of the Appendix

    PubMed Central

    Al-Shaikh, Abdulrahman F.; Darwish, Abdulla; Nagaraj, Veena; Alsada, Abeer

    2015-01-01

    We present a case of the rare combination of unilateral ovarian leiomyoma, uterine leiomyoma, and goblet cell carcinoid tumor of the appendix in a premenopausal woman who presented with right iliac pain. Immunohistochemistry study for desmin (muscle marker) and chromogranin and synaptophysin (neuroendocrine markers) confirmed immunophenotyping origin. Interestingly, both tumors showed positive reaction for estrogen receptor. To our knowledge, such a combination has not been reported previously in the literature. In this paper, the pathogenesis and differential diagnosis of both types of tumors are discussed. PMID:25685587

  19. Carcinoid syndrome, acromegaly, and hypoglycemia due to an insulin-secreting neuroendocrine tumor of the liver.

    PubMed

    Furrer, J; Hättenschwiler, A; Komminoth, P; Pfammatter, T; Wiesli, P

    2001-05-01

    We report a patient with a hepatic neuroendocrine tumor showing an extraordinary change of the tumor's humoral manifestations from a clinically documented extrapituitary acromegaly and a typical carcinoid syndrome toward a hyperinsulinemic hypoglycemia syndrome. At the primary manifestation of the tumor, an increased serum level of insulin-like growth factor I due to overproduction of GHRH and an increased urinary excretion of 5-hydroxyindoleacetic acid were found. The clinical manifestation of the GHRH excess was an arthralgia, which resolved completely after operative tumor debulking and normalization of insulin-like growth factor I and GHRH serum levels. The secretion of serotonin from the tumor resulted in a typical carcinoid syndrome including right-sided valvular heart disease. On the later course of the disease, the humoral manifestations of the tumor were supplemented by the secretion of insulin, leading to recurrent severe hyperinsulinemic hypoglycemia. The hepatic origin of hyperinsulinism was demonstrated by selective arterial calcium stimulation. Moreover, tumor cells revealed insulin and C-peptide immunoreactivity in the immunohistochemical analysis. The patient died 8 yr after the initial diagnosis of the tumor, and a carefully performed autopsy procedure confirmed the absence of any extrahepatic tumor manifestation. PMID:11344231

  20. Carcinoid syndrome, acromegaly, and hypoglycemia due to an insulin-secreting neuroendocrine tumor of the liver.

    PubMed

    Furrer, J; Hättenschwiler, A; Komminoth, P; Pfammatter, T; Wiesli, P

    2001-05-01

    We report a patient with a hepatic neuroendocrine tumor showing an extraordinary change of the tumor's humoral manifestations from a clinically documented extrapituitary acromegaly and a typical carcinoid syndrome toward a hyperinsulinemic hypoglycemia syndrome. At the primary manifestation of the tumor, an increased serum level of insulin-like growth factor I due to overproduction of GHRH and an increased urinary excretion of 5-hydroxyindoleacetic acid were found. The clinical manifestation of the GHRH excess was an arthralgia, which resolved completely after operative tumor debulking and normalization of insulin-like growth factor I and GHRH serum levels. The secretion of serotonin from the tumor resulted in a typical carcinoid syndrome including right-sided valvular heart disease. On the later course of the disease, the humoral manifestations of the tumor were supplemented by the secretion of insulin, leading to recurrent severe hyperinsulinemic hypoglycemia. The hepatic origin of hyperinsulinism was demonstrated by selective arterial calcium stimulation. Moreover, tumor cells revealed insulin and C-peptide immunoreactivity in the immunohistochemical analysis. The patient died 8 yr after the initial diagnosis of the tumor, and a carefully performed autopsy procedure confirmed the absence of any extrahepatic tumor manifestation.

  1. Primary renal carcinoid tumour with lung metastasis misdiagnosed as renal cell carcinoma.

    PubMed

    Daboul, Nour; Monga, Dulabh; Bunker, Mark

    2016-01-01

    A 58-year-old man with a history of metastatic renal cell carcinoma (RCC) diagnosed 10 years prior, status post right nephrectomy, presented for evaluation of pulmonary nodules. A year after the nephrectomy, he had undergone cutaneous metastasectomy in the right flank area, and a further 2 years later he had had his second cutaneous metastasectomy in the right chest wall. Both cutaneous pathologies had, at the time, shown metastatic neoplasm with histological features compatible with those of the previous renal tumour. He was treated with sorafenib. 3 years later he developed asymptomatic pulmonary nodules, which gradually doubled in size over the next 2.5 years. He underwent bronchoscopy and left lower lobe biopsy. Pathology revealed a metastatic renal carcinoid/neuroendocrine tumour. Second review of the previous renal neoplasm and the cutaneous metastatic pathology showed trabecular architecture, consistent with carcinoid, but mimicking the long parallel arrays that have been described in some cases of papillary RCC. PMID:26951438

  2. Update in Cancer Chemotherapy: Gastrointestinal Cancer, Cancer of the Stomach and Carcinoid Tumors

    PubMed Central

    Wright, Jane C.

    1986-01-01

    Cancer chemotherapy in the treatment of advanced gastric cancer provides only palliation with perhaps increased survival time in some patients. The primary treatment of gastric carcinomas is surgical, as this is the only hope for cure. It is estimated that 80 to 85 percent of patients with newly diagnosed cases of stomach cancer will be dead of their disease within five years. Radiation therapy alone is seldom employed, except as a palliative measure to control hemorrhage or pain. There are no data to suggest that postoperative radiation increases survival rates. Single-agent chemotherapy is of temporary palliative value in 20 to 30 percent of cases with a duration of response from three to five months. Combination chemotherapy has shown a somewhat higher response rate than single-agent therapy. In advanced gastric cancer, there is no evidence of improved long-term disease-free survival rates with any combination yet reported. The treatment of carcinoid cancer of the intestinal tract is surgical removal, as this offers the only hope of cure. Radiation therapy is of little benefit, except for moderate palliation in cases of extensive liver metasasis. Carcinoid cancers are moderately sensitive to chemotherapy. While some adjuvant chemotherapy trials suggest improvement, major survival gains remain to be demonstrated. Uncertainty as to the role of chemotherapy in the treatment of gastrointestinal cancers is probably due to lack of data. PMID:3528508

  3. Effective palliative treatment of metastatic carcinoid tumors with intra-arterial chemotherapy/chemoembolization combined with octreotide acetate.

    PubMed

    Hajarizadeh, H; Ivancev, K; Mueller, C R; Fletcher, W S; Woltering, E A

    1992-05-01

    Survival in patients with metastatic carcinoid tumors is dependent on control of tumor growth and adequate palliation of vasoactive amine-induced symptoms of flushing, diarrhea, wheezing, and valvular heart disease. Eight patients with carcinoid tumors metastatic to the liver were treated with long-term octreotide acetate therapy (100 to 500 micrograms three times a day), intra-arterial 5-fluorouracil infusion (2 g/day x 5 days), and hepatic tumor chemoembolization. All eight patients became asymptomatic and have remained so with a mean follow-up duration of 22 months from the time of first infusion. Following institution of subcutaneous octreotide acetate, intra-arterial infusion, and tumor chemoembolization, all patients are alive with a mean survival of 40 months from the time of diagnosis of carcinoid syndrome (range: 2 to 108 months). Four patients had greater than a 50% decrease in tumor size after therapy (mean follow-up duration: 10.6 months), and the other four patients have had stable disease after institution of therapy. It appears that combinations of long-term subcutaneous administration of octreotide acetate, intra-arterial 5-fluorouracil, and tumor chemoembolization effectively control progressive liver metastasis and provide excellent symptomatic palliation in patients with hepatic metastasis from functional carcinoid tumors.

  4. Combination of carbonic anhydrase inhibitor, acetazolamide, and sulforaphane, reduces the viability and growth of bronchial carcinoid cell lines

    PubMed Central

    2013-01-01

    Background Bronchial carcinoids are pulmonary neuroendocrine cell-derived tumors comprising typical (TC) and atypical (AC) malignant phenotypes. The 5-year survival rate in metastatic carcinoid, despite multiple current therapies, is 14-25%. Hence, we are testing novel therapies that can affect the proliferation and survival of bronchial carcinoids. Methods In vitro studies were used for the dose–response (AlamarBlue) effects of acetazolamide (AZ) and sulforaphane (SFN) on clonogenicity, serotonin-induced growth effect and serotonin content (LC-MS) on H-727 (TC) and H-720 (AC) bronchial carcinoid cell lines and their derived NOD/SCID mice subcutaneous xenografts. Tumor ultra structure was studied by electron microscopy. Invasive fraction of the tumors was determined by matrigel invasion assay. Immunohistochemistry was conducted to study the effect of treatment(s) on proliferation (Ki67, phospho histone-H3) and neuroendocrine phenotype (chromogranin-A, tryptophan hydroxylase). Results Both compounds significantly reduced cell viability and colony formation in a dose-dependent manner (0–80 μM, 48 hours and 7 days) in H-727 and H-720 cell lines. Treatment of H-727 and H-720 subcutaneous xenografts in NOD/SCID mice with the combination of AZ + SFN for two weeks demonstrated highly significant growth inhibition and reduction of 5-HT content and reduced the invasive capacity of H-727 tumor cells. In terms of the tumor ultra structure, a marked reduction in secretory vesicles correlated with the decrease in 5-HT content. Conclusions The combination of AZ and SFN was more effective than either single agent. Since the effective doses are well within clinical range and bioavailability, our results suggest a potential new therapeutic strategy for the treatment of bronchial carcinoids. PMID:23927827

  5. [Pulmonary Carcinoid Tumor with Cushing's Syndrome in a Patient who Underwent Pulmonary Resection by Video-Assisted Thoracic Surgery;Report of a Case].

    PubMed

    Sato, Hiroshi; Mishina, Taijiro; Miyajima, Masahiro; Watanabe, Atsushi

    2015-07-01

    Pulmonary carcinoid tumor with Cushing's syndrome is comparatively rare disease. It is difficult to make an early diagnosis due to small size lesion in its early stage. We report a case of pulmonary carcinoid tumor with Cushing's syndrome successfully localised by positron emission tomography/computed tomography and was resected in the early stage. The levels of serum cortisol and adrenocorticotropic hormone( ACTH) decreased immediately after surgery, and the symptoms of Cushing's syndrome were relieved.

  6. Endobronchial Hamartoma Subtotally Occluding the Right Main Bronchus and Mimicking Bronchial Carcinoid Tumor

    PubMed Central

    Lococo, Filippo; Galeone, Carla; Lasagni, Luciano; Carbonelli, Cristiano; Tagliavini, Elena; Piro, Roberto; Zucchi, Luigi; Sgarbi, Giorgio

    2016-01-01

    Abstract Hamartomas are very rarely identified as an endobronchial lesion. Herein, we describe a peculiar case of a 55-year-old woman with persistent cough and increasing dyspnea and radiological detection of a solid lesion subtotally occluding the main right bronchus. Despite the radiological and radiometabolic (18-fluoro-2-deoxy-d-glucose positron emission tomography/computer tomography scan) features were highly suspected for bronchial carcinoid, the definitive diagnosis after endoscopic removal was indicative of an endobronchial hamartoma. When considering differential diagnosis of an endobronchial lesion, the physicians should take firmly in mind such rare entity and, accordingly, bronchoscopy and bronchoscopic biopsy should be done as first step in management of all cases presenting with endobronchial lesions. PMID:27082600

  7. GASTRIC CARCINOID TYPE 1 IN A PATIENT WITH AUTOIMMUNE POLYGLANDULAR SYNDROME: ADDITIONAL ENDOCRINOLOGICAL EVALUATION REQUIRED.

    PubMed

    Vrkljan, Ana Marija; Grasić, David; Kruljac, Ivan; Nikolić, Marko; Filipović-Cugura, Jaksa; Ulamec, Monika; Kovacić, Ksenija; Babić, Nenad; Ljubicić, Neven

    2015-12-01

    Autoimmune polyglandular syndrome by definition consists of two or more endocrinological insufficiencies or two organ specific autoimmune diseases. There are no stringent criteria for endocrinological evaluation of patients with one endocrine insufficiency. However, detailed endocrinological evaluation should be undertaken in patients with two autoimmune diseases. Additionally, follow up thereafter should be a must in these patients in order to avoid the possibility of not diagnosing subsequent autoimmune diseases that can occur. The aim of this case report is to point to the necessity of endocrinological screening to be made in patients presenting with gastric carcinoid type 1. We report on a 62-year-old woman who was diagnosed with primary hypothyroidism in 1993. In 2011, she was re-admitted to the hospital due to increasing fatigue. Macrocytic anemia, low vitamin B12 levels and positive parietal antibodies confirmed pernicious anemia. Furthermore, she underwent gastroscopy, which revealed two polyps in the corpus of the stomach and one in the fornix. Endoscopic mucosal resection was performed and histopathologic analysis confirmed three G1 gastric carcinoids (Ki67 2%). Additional endocrinological evaluation disclosed positive glutamic acid decarboxylase antibodies, but normal fasting and postprandial glucose and HbA1c. In 2013, she was diagnosed with glucose intolerance and subsequently with latent autoimmune diabetes of adulthood. Plasma glucose and HbA1c normalized after dietary intervention. Due to the increase of serum chromogranin A, prophylactic antrectomy was performed in 2014. The patient is still followed-up and has normal chromogranin A, gastrin and HbA1c levels. PMID:27017730

  8. AACE/ACE DISEASE STATE CLINICAL REVIEW: DIAGNOSIS AND MANAGEMENT OF MIDGUT CARCINOIDS

    PubMed Central

    Katznelson, Laurence; Vinik, Aaron I.; Wong, Richard; Randolph, Gregory

    2016-01-01

    Objective Neuroendocrine tumors (NETs) are a collection of complex tumors that arise from the diffuse endocrine system, primarily from the digestive tract. Carcinoid tumors most commonly originate from the small intestine. These tumors are either referred to as small intestinal neuroendocrine tumors or midgut carcinoids (MGCs). The purpose of this review article is to survey the diagnostic and therapeutic pathways for patients with MGC and provide an overview of the complex multidisciplinary care involved in improving their quality of life, treatment outcomes, and survival. Methods The current literature regarding the diagnosis and management of MGCs was reviewed. Results Dry flushing and secretory diarrhea are the hallmarks of the clinical syndrome of MGC. Managing MGC requires attention to the overall symptom complex, including the physical effects of the tumor and biomarker levels. The somatostatin analogs (SAs) octreotide and lanreotide are highly efficacious for symptomatic improvement. MGCs require resection to encompass the primary tumor and mesenteric lymph node metastases and should include cholecystectomy if the patient is likely to receive SA therapy. Debulking of liver metastasis by resection in combination with ablative therapies and other liver-directed modalities may help palliate symptoms and hormonal overproduction in carefully selected patients. Quality of life is an important measure of patients’ perception of the burden of their disease and impact of treatment modalities and may be a useful guide in deciding changes in therapy to alter apparent health status. Conclusion MGC is a challenging malignancy that requires the input of a multidisciplinary team to develop the best treatment plan. Consultation with expert centers that specialize in NETs may also be indicated for complex cases. With expert care, patients can be cured or live with the disease and enjoy good quality of life. PMID:25962092

  9. Paraneoplastic Cushing's syndrome associated with bronchopulmonary carcinoid tumor in youth: A case report and review of the literature

    PubMed Central

    LI, WEN-YA; LIU, XU-DONG; LI, WEI-NAN; DONG, SI-YUAN; QU, XIAO-HAN; GONG, SHU-LEI; SHAO, MING-RUI; ZHANG, LIN

    2016-01-01

    Paraneoplastic Cushing's syndrome (CushingPS) caused by bronchopulmonary carcinoid tumors presents a diagnostic challenge for clinicians. The present study reports the case of an 18-year-old male patient presenting with rapid weight gain, polyuria, polydipsia and progressive muscle weakness. Chemical and imaging findings suggested ectopic secretion of adrenocorticotropin. Whole-body 18fluorine-fluorodeoxyglucose (18FDG-PET/CT) positron-emission tomography revealed an increased uptake of 18FDG-PET/CT in the right middle lung mass and lobar lymph node. Postoperative pathology confirmed the presence of a typical carcinoid, as well as a lobar lymph node metastasis. The patient underwent a right middle lobectomy with mediastinal lymph node resection, which resulted in symptom clearance, followed by rapid weight loss. No CushingPS or tumor recurrence was observed at the 3-month postoperative follow-up. PMID:27347101

  10. Carcinoid syndrome

    MedlinePlus

    ... neck, or upper chest Diarrhea Heart palpitations Low blood pressure Skin lesions on the face called telangiectasias Wheezing Sometimes symptoms are brought on by physical exertion, or eating or drinking things such as blue cheeses, chocolate, or red wine.

  11. Temsirolimus and Bevacizumab in Treating Patients With Advanced Endometrial, Ovarian, Liver, Carcinoid, or Islet Cell Cancer

    ClinicalTrials.gov

    2016-07-05

    Adult Hepatocellular Carcinoma; Advanced Adult Hepatocellular Carcinoma; Endometrial Serous Adenocarcinoma; Localized Non-Resectable Adult Liver Carcinoma; Lung Carcinoid Tumor; Malignant Pancreatic Gastrinoma; Malignant Pancreatic Glucagonoma; Malignant Pancreatic Insulinoma; Malignant Pancreatic Somatostatinoma; Metastatic Digestive System Neuroendocrine Tumor G1; Ovarian Carcinosarcoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Surface Papillary Adenocarcinoma; Pancreatic Alpha Cell Adenoma; Pancreatic Beta Cell Adenoma; Pancreatic Delta Cell Adenoma; Pancreatic G-Cell Adenoma; Pancreatic Polypeptide Tumor; Recurrent Adult Liver Carcinoma; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Pancreatic Neuroendocrine Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IIIC Uterine Corpus Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma

  12. 5-HTP induced diarrhea as a carcinoid syndrome model in mice?

    PubMed

    Bourin, M; Hascoet, M; Deguiral, P

    1996-01-01

    Serotonin (5-HT) is present in the gastrointestinal tract and is probably one of the compounds responsible for diarrhea in patients presenting with carcinoid syndrome. Intraperitoneal administration of L-5-hydroxytryptophan (L-5-HTP) at doses of 25 to 100 mg/kg dramatically increase defecation in mice. In this new paradigm, counting fecal boli deposited is simple and the appraised or inhibition of diarrhea induced by ip 25 mg/kg of L-5-HIP is very clear, with a good reproducibility of scores. L-5-HTP needs to be metabolized into 5-HT to be active; benserazide, an inhibitor of decarboxylase, antagonized the diarrhea induced by 5-HT. Among the 5-HT antagonists used in interaction with 5-HT, only these of the 5-HT3 type (ondansetron, granisetron, tropisetron) and, to a lesser extent 5-HT2 type (ritanserin), decreased the diarrhea induced by 5-HTP. The 5-HT4 receptor agonists from the benzamide family (metoclopramide and zacopride) increased defecation in mice but the effect failed to reach statistical significance.

  13. Overexpression of PY1289-HER3 in sporadic pulmonary carcinoid from patients bearing MEN1 gene variants

    PubMed Central

    LATTANZIO, ROSSANO; VESCHI, SERENA; ACETO, GITANA MARIA; CURIA, MARIA CRISTINA; CAMA, ALESSANDRO; DE LELLIS, LAURA; FANTINI, FABIANA; ANGELUCCI, DOMENICO; IACOBELLI, STEFANO; PIANTELLI, MAURO; BATTISTA, PASQUALE

    2016-01-01

    The present study aimed to investigate the expression of human epidermal growth factor receptors (HERs) (HER1/HER2/HER3/HER4) and their phosphorylated forms (p-HER1/p-HER2/p-HER3/p-HER4) in pulmonary carcinoids (PCs). HER and p-HER protein expression was assessed by immunohistochemistry on tissue microarrays in 37 specimens of sporadic PCs, 29 typical carcinoids (TCs) and 8 atypical carcinoids (ACs). When compared with the ACs, the TCs did not exhibit any differences in terms of HER/p-HER expression. The tumors of this study have previously been characterized for the expression of menin and the mutational status of menin 1 (MEN1), a gene strongly implicated in the pathogenesis of PCs. In the present study, it was found that the cytoplasmic (‘disarrayed’), but not nuclear (‘arrayed’) expression of menin was positively correlated with HER3 (P=0.004), HER4 (P=0.015), p-HER1 (P=0.005), p-HER3 (P<0.001), and p-HER4 (P=0.001) expression. Moreover, HER3 and p-HER3 were found to be significantly more expressed in PCs with MEN1 variants, than in tumors with MEN1 wild-type (P=0.000 and P=0.025, respectively). These findings suggest the potential clinical use of HER inhibitors in the treatment of patients with PCs, particularly for individuals with p-HER3-positive PCs harboring MEN1 gene variants. PMID:27347164

  14. The effect of a somatostatin analogue on the release of hormones from human midgut carcinoid tumour cells.

    PubMed

    Wängberg, B; Nilsson, O; Theodorsson, E; Dahlström, A; Ahlman, H

    1991-07-01

    The use of a somatostatin analogue (SMS 201-995) has greatly facilitated the treatment of patients with the midgut carcinoid syndrome. Clinical studies have shown that SMS reduces the peripheral levels of tumour-produced serotonin (5-HT) and tachykinins, e.g. neuropeptide K (NPK), basally and after pentagastrin provocation. Some studies have indicated an inhibitory effect of SMS on tumour cell growth as well. In the present study we have investigated the effects of SMS on four different human midgut carcinoid tumours maintained in long term culture. Media levels of 5-HT and NPK-LI in tumour cell cultures decreased rapidly during incubation with SMS (10(-8)-10(-10) M) in all four tumours studied without evidence for tachyphylaxis (up to 6 weeks observation period). SMS treatment (10(-8) M) during 4 days reduced the media concentrations of 5-HT by 56%, while the intracellular contents of 5-HT were decreased by 27% indicating dual inhibitory effects on synthesis and secretion of 5-HT from tumour cells. The DNA contents of cultures were not affected by SMS (10(-8) M or 10(-10) M) treatment for 4 or 14 days. When tumour cell cultures were challenged with isoprenaline (IP) (10(-6) M) no reduction of the IP induced release of 5-HT could be detected after pretreatment of tumour cell cultures with SMS (10(-8) M) for 1 h, 4 h or 4 days. These studies provide evidence for a direct action of the somatostatin analogue on midgut carcinoid tumour cells, reducing both synthesis and secretion of hormones from tumour cells. This effect appears not to be related to inhibition of tumour cell growth. The inhibition of 5-HT secretion from tumour cells by SMS seems to operate via a second messenger system different from the one mediating the beta-adrenoceptor stimulated release of 5-HT. PMID:1713051

  15. Atypical carcinoid and large cell neuroendocrine carcinoma of the lung: a proteomic dataset from formalin-fixed archival samples.

    PubMed

    Tanca, Alessandro; Addis, Maria Filippa; Pisanu, Salvatore; Abbondio, Marcello; Pagnozzi, Daniela; Eccher, Albino; Rindi, Guido; Cossu-Rocca, Paolo; Uzzau, Sergio; Fanciulli, Giuseppe

    2016-06-01

    Here we present a dataset generated using formalin-fixed paraffin-embedded archival samples from two rare lung neuroendocrine tumor subtypes (namely, two atypical carcinoids, ACs, and two large-cell neuroendocrine carcinomas, LCNECs). Samples were subjected to a shotgun proteomics pipeline, comprising full-length protein extraction, SDS removal through spin columns, in solution trypsin digestion, long gradient liquid chromatography peptide separation and LTQ-Orbitrap mass spectrometry analysis. A total of 1260 and 2436 proteins were identified in the AC and LCNEC samples, respectively, with FDR <1%. MS data are available in the PeptideAtlas repository at http://www.peptideatlas.org/PASS/PASS00375.

  16. [Unilateral hyperlucent lung induced by a carcinoid tumor: comments on the differential diagnosis and mechanisms of hypoperfusion].

    PubMed

    Schmitz, N; Bugnet, A-S; Demian, M; Massard, G; De Blay, F; Pauli, G

    2005-04-01

    We report the case of a 35-year-old woman in whom a systematic thoracic x-ray led to the diagnosis of unilateral hyperlucent lung due to a carcinoid tumor obstructing the main left bronchus almost completely. Injected computed tomography permitted diagnosis of left lung hypoperfusion and visualization of the tumor. After enlarged inferior left lobar resection, normal perfusion was observed six months later on the isotopic lung perfusion scan. Other reported causes of unilateral hyperlucent lung are discussed as well as pathophysiological mechanisms of lung hypoperfusion and hypoxic vasoconstriction.

  17. Atypical carcinoid and large cell neuroendocrine carcinoma of the lung: a proteomic dataset from formalin-fixed archival samples

    PubMed Central

    Tanca, Alessandro; Addis, Maria Filippa; Pisanu, Salvatore; Abbondio, Marcello; Pagnozzi, Daniela; Eccher, Albino; Rindi, Guido; Cossu-Rocca, Paolo; Uzzau, Sergio; Fanciulli, Giuseppe

    2016-01-01

    Here we present a dataset generated using formalin-fixed paraffin-embedded archival samples from two rare lung neuroendocrine tumor subtypes (namely, two atypical carcinoids, ACs, and two large-cell neuroendocrine carcinomas, LCNECs). Samples were subjected to a shotgun proteomics pipeline, comprising full-length protein extraction, SDS removal through spin columns, in solution trypsin digestion, long gradient liquid chromatography peptide separation and LTQ-Orbitrap mass spectrometry analysis. A total of 1260 and 2436 proteins were identified in the AC and LCNEC samples, respectively, with FDR <1%. MS data are available in the PeptideAtlas repository at http://www.peptideatlas.org/PASS/PASS00375. PMID:27054153

  18. [Unilateral hyperlucent lung induced by a carcinoid tumor: comments on the differential diagnosis and mechanisms of hypoperfusion].

    PubMed

    Schmitz, N; Bugnet, A-S; Demian, M; Massard, G; De Blay, F; Pauli, G

    2005-04-01

    We report the case of a 35-year-old woman in whom a systematic thoracic x-ray led to the diagnosis of unilateral hyperlucent lung due to a carcinoid tumor obstructing the main left bronchus almost completely. Injected computed tomography permitted diagnosis of left lung hypoperfusion and visualization of the tumor. After enlarged inferior left lobar resection, normal perfusion was observed six months later on the isotopic lung perfusion scan. Other reported causes of unilateral hyperlucent lung are discussed as well as pathophysiological mechanisms of lung hypoperfusion and hypoxic vasoconstriction. PMID:16012363

  19. Atypical carcinoid and large cell neuroendocrine carcinoma of the lung: a proteomic dataset from formalin-fixed archival samples.

    PubMed

    Tanca, Alessandro; Addis, Maria Filippa; Pisanu, Salvatore; Abbondio, Marcello; Pagnozzi, Daniela; Eccher, Albino; Rindi, Guido; Cossu-Rocca, Paolo; Uzzau, Sergio; Fanciulli, Giuseppe

    2016-06-01

    Here we present a dataset generated using formalin-fixed paraffin-embedded archival samples from two rare lung neuroendocrine tumor subtypes (namely, two atypical carcinoids, ACs, and two large-cell neuroendocrine carcinomas, LCNECs). Samples were subjected to a shotgun proteomics pipeline, comprising full-length protein extraction, SDS removal through spin columns, in solution trypsin digestion, long gradient liquid chromatography peptide separation and LTQ-Orbitrap mass spectrometry analysis. A total of 1260 and 2436 proteins were identified in the AC and LCNEC samples, respectively, with FDR <1%. MS data are available in the PeptideAtlas repository at http://www.peptideatlas.org/PASS/PASS00375. PMID:27054153

  20. Hypokalaemia: common but not always benign. Severe, persistent hypokalaemia secondary to ectopic ACTH from a carcinoid tumour

    PubMed Central

    Mahmood, Muhammad Muzaffar; John, Kurien

    2012-01-01

    Hypokalaemia is a common and often benign observation. There is usually an obvious underlying cause for the anomaly. However, hypokalaemia can very rarely be the sole presentation of a more sinister disease. A high index of suspicion and a systematic approach are therefore required to avoid delays in the management, especially in the context of presentation to a medical team. We present a case of a patient with severe and persistent hypokalaemia due to ectopic adrenocorticotropic hormone (ACTH) secretion secondary to a carcinoid tumour. The case report is followed by a brief discussion on the approach to the management of hypokalaemia and additional tests to confirm ectopic ACTH. PMID:23152181

  1. [Carcinoid tumours of the lung and definition of the medico-legal term "lung cancer" used in the list of occupational disease in Germany--results of the German Mesothelioma Register].

    PubMed

    Neumann, V; Fischer, M; Tannapfel, A

    2008-09-01

    Carcinoid tumours are considered to be malignant epithelial tumours according to the recent WHO classification. This study is based on the examinations of tissue from 108 patients with carcinoid tumours. Our data agree with those of other studies: carcinoid tumours developed mainly in the right lung (40 %) and the lower lobe (30 %), mean age was 56 years, typical carcinoid tumours (74 %) predominated, comparatively high proportion of females (32 %), the mean latency period after asbestos exposure - assuming asbestos as one causal factor - was 35 years. A higher incidence of carcinoid tumours (1.3 %) in the collective of the mesothelioma register compared to the incidence in the collective of all lung carcinomas (1 - 2 %) was not observed. The increased pulmonary asbestos burden analysed in 26 % of patients is explained by the exposure-dependent selection of patients in the register. So far, no association between smoking habits or exposure to other, i. e., occupational pollutions and the development of carcinoid tumours could be established. In the list of occupational diseases (No. 4104) the term "lung cancer" is used without further specification. Thus the following question remains open for discussion: does the term "lung cancer" include carcinoid tumours such as malignant epithelial lung tumours, or is it restricted to the common subtypes such as small cell carcinoma, squamous cell carcinoma, adenocarcinoma, large cell carcinoma with regard to occupational disease and compensation?

  2. Carcinoid tumor associated with adjacent dysplastic columnar epithelium in the renal pelvis: A case report and literature review.

    PubMed

    Kim, Sung Sun; Choi, Chan; Kang, Taek Won; Choi, Yoo Duk

    2016-01-01

    Carcinoid tumors are well documented in the pulmonary and gastrointestinal systems, but very rare in the urinary tract, especially in the renal pelvis. We report on a 60-year-old female patient who presented with left flank pain and fever. Abdominal computed tomography demonstrated a heterogeneously enhancing mass in the left renal pelvis and a stone at the left proximal ureter. Multiple parenchymal lesions were also observed, which were identified as uneven caliectasis displaying air-fluid levels and renal parenchymal atrophy. The patient underwent simple nephro-ureterectomy. Macroscopically, a polypoid mass was observed in the renal pelvis. Microscopically, the tumor revealed acinar, tubular, and solid pattern and was composed of small, monotonous and hyperchromatic cells. Lining epithelia in renal pelvis and ureter revealed columnar epithelia with dysplastic change. The tumor cells were positive for chromogranin A, synaptophysin, CD56, and focally positive for cytokeratin. Immunohistochemical staining of synaptophysin and chromogranin A highlighted the neuroendocrine cells in the columnar epithelium. Ki-67 (1:50; MIB-1) labeling index was less than 1% in the area with highest uptake. We report here a case of carcinoid tumor of the renal pelvis that was associated with adjacent dysplastic columnar epithelium. PMID:26644387

  3. Challenges in the Diagnosis and Management of Well-Differentiated Neuroendocrine Tumors of the Lung (Typical and Atypical Carcinoid): Current Status and Future Considerations

    PubMed Central

    2015-01-01

    Neuroendocrine tumors (NET) of the lung represent approximately 25% of all primary lung tumors and can be classified as low grade (typical carcinoids), intermediate grade (atypical carcinoids), or high grade (large cell neuroendocrine carcinoma or small cell lung carcinoma). Low- and intermediate-grade lung NET are increasingly recognized as biologically distinct from high-grade lung NET based on clinical behavior and underlying molecular abnormalities. This review summarizes current knowledge and challenges in the diagnosis and management of low- and intermediate-grade lung NET. Accurate histopathologic classification of lung NET is critical to determining appropriate treatment options but can be challenging even for experts. For low- and intermediate-grade lung NET, surgery remains the mainstay of treatment for localized disease. Although no standard systemic therapy has been established for the treatment of advanced, unresectable disease, a number of promising treatment options are emerging, including somatostatin analogs, temozolomide-based chemotherapy, targeted therapy with mammalian target of rapamycin or vascular endothelial growth factor inhibitors, and peptide receptor radionuclide therapy. Given the difficulty in accurately diagnosing these tumors, and the paucity of data supporting establishment of standard systemic therapy options, management of patients within the setting of a multidisciplinary team, including specialists with expertise in NET, is recommended. Ongoing and future clinical trials hopefully will provide stronger evidence to support treatment recommendations for low- and intermediate-grade lung NET. Implications for Practice: Treatment of neuroendocrine tumors (NET), particularly those of lung origin, continues to evolve. This review seeks to educate oncologists on the most up-to-date options and supporting data regarding management of two rare lung neoplasms, typical and atypical carcinoid tumors. Although surgical resection has been the

  4. Regional Gastrointestinal Transit Times in Patients With Carcinoid Diarrhea: Assessment With the Novel 3D-Transit System

    PubMed Central

    Gregersen, Tine; Haase, Anne-Mette; Schlageter, Vincent; Gronbaek, Henning; Krogh, Klaus

    2015-01-01

    Background/Aims The paucity of knowledge regarding gastrointestinal motility in patients with neuroendocrine tumors and carcinoid diarrhea restricts targeted treatment. 3D-Transit is a novel, minimally invasive, ambulatory method for description of gastrointestinal motility. The system has not yet been evaluated in any group of patients. We aimed to test the performance of 3D-Transit in patients with carcinoid diarrhea and to compare the patients’ regional gastrointestinal transit times (GITT) and colonic motility patterns with those of healthy subjects. Methods Fifteen healthy volunteers and seven patients with neuroendocrine tumor and at least 3 bowel movements per day were investigated with 3D-Transit and standard radiopaque markers. Results Total GITT assessed with 3D-Transit and radiopaque markers were well correlated (Spearman’s rho = 0.64, P = 0.002). Median total GITT was 12.5 (range: 8.5–47.2) hours in patients versus 25.1 (range: 13.1–142.3) hours in healthy (P = 0.007). There was no difference in gastric emptying (P = 0.778). Median small intestinal transit time was 3.8 (range: 1.4–5.5) hours in patients versus 4.4 (range: 1.8–7.2) hours in healthy subjects (P = 0.044). Median colorectal transit time was 5.2 (range: 2.9–40.1) hours in patients versus 18.1 (range: 5.0–134.0) hours in healthy subjects (P = 0.012). Median frequency of pansegmental colonic movements was 0.45 (range: 0.03–1.02) per hour in patients and 0.07 (range: 0–0.61) per hour in healthy subjects (P = 0.045). Conclusions Three-dimensional Transit allows assessment of regional GITT in patients with diarrhea. Patients with carcinoid diarrhea have faster than normal gastrointestinal transit due to faster small intestinal and colorectal transit times. The latter is caused by an increased frequency of pansegmental colonic movements. PMID:26130638

  5. Use of radioguided surgery with [111In]-pentetreotide in the management of an ACTH-secreting bronchial carcinoid causing ectopic Cushing's syndrome.

    PubMed

    Grossrubatscher, E; Vignati, F; Dalino, P; Possa, M; Belloni, P A; Vanzulli, A; Bramerio, M; Marocchi, A; Rossetti, O; Zurleni, F; Loli, P

    2005-01-01

    Intraoperative [111In]-pentetreotide scintigraphy with a hand-held gamma detector probe has recently been proposed to increase the intraoperative detection rate of small neuroendocrine tumors and their metastases. We report a case of a 28-yr-old woman with ectopic Cushing's syndrome due to an ACTH-secreting bronchial carcinoid, in whom the use of radioguided surgery improved disease management. At presentation, radiolabeled pentetreotide scintigraphy was the only procedure able to detect the ectopic source of ACTH. After radiologic confirmation, the patient underwent removal of a bronchial carcinoid, with disease persistence. After surgery, pentetreotide scintigraphy showed pathologic uptake in the mediastinum not previously detected at surgery and only subsequently confirmed by radiologic studies. Despite a second thoracic exploration, hormonal, scintigraphic, and radiological evidence of residual disease persisted. Radioguided surgery was then performed using a hand-held gamma probe 48 h after iv administration of a tracer dose of radiolabeled [111In-DTPA-D-Phe1]-pentetreotide, which permitted detection and removal of multiple residual mediastinal lymph node metastases. Clinical and radiologic cure, with no evidence of tracer uptake at pentetreotide scintigraphy, was subsequently observed. The use of an intraoperative gamma counter appears a promising procedure in the management of metastatic ACTH-secreting bronchial carcinoids. PMID:15816375

  6. Use of radioguided surgery with [111In]-pentetreotide in the management of an ACTH-secreting bronchial carcinoid causing ectopic Cushing's syndrome.

    PubMed

    Grossrubatscher, E; Vignati, F; Dalino, P; Possa, M; Belloni, P A; Vanzulli, A; Bramerio, M; Marocchi, A; Rossetti, O; Zurleni, F; Loli, P

    2005-01-01

    Intraoperative [111In]-pentetreotide scintigraphy with a hand-held gamma detector probe has recently been proposed to increase the intraoperative detection rate of small neuroendocrine tumors and their metastases. We report a case of a 28-yr-old woman with ectopic Cushing's syndrome due to an ACTH-secreting bronchial carcinoid, in whom the use of radioguided surgery improved disease management. At presentation, radiolabeled pentetreotide scintigraphy was the only procedure able to detect the ectopic source of ACTH. After radiologic confirmation, the patient underwent removal of a bronchial carcinoid, with disease persistence. After surgery, pentetreotide scintigraphy showed pathologic uptake in the mediastinum not previously detected at surgery and only subsequently confirmed by radiologic studies. Despite a second thoracic exploration, hormonal, scintigraphic, and radiological evidence of residual disease persisted. Radioguided surgery was then performed using a hand-held gamma probe 48 h after iv administration of a tracer dose of radiolabeled [111In-DTPA-D-Phe1]-pentetreotide, which permitted detection and removal of multiple residual mediastinal lymph node metastases. Clinical and radiologic cure, with no evidence of tracer uptake at pentetreotide scintigraphy, was subsequently observed. The use of an intraoperative gamma counter appears a promising procedure in the management of metastatic ACTH-secreting bronchial carcinoids.

  7. Patient characteristics, treatment and survival in pulmonary carcinoid tumours: an analysis from the UK National Lung Cancer Audit

    PubMed Central

    Hobbins, Stephanie; West, Doug; Peake, Michael; Beckett, Paul; Woolhouse, Ian

    2016-01-01

    Objectives Pulmonary carcinoid (PC) is a rare tumour with good prognosis following surgical resection. However, little is known regarding patient characteristics and use of other treatments modalities. Our objective was to review patient characteristics, treatment and survival for patients with PC and contrast these results with other forms of non-small cell lung cancer (NSCLC). Setting Audit data from UK National Lung Cancer Audit (NLCA) 2008–2013. Participants 184 906 lung cancer cases were submitted to the NLCA. Outcome measures Primary outcome—survival rates between PC and NSCLC. Secondary outcome—differences in performance status, lung function and treatment modality between PC and NSCLC. Results PC histology was recorded in 1341 (0.73%) patients and non-carcinoid NSCLC histology in 162 959 (87.4%) cases. 91% of patients with PC had good performance status (Eastern Cooperative Oncology Group (ECOG) 0–1), compared with only 53% of NSCLC. 66% of PC had localised disease. Of all PC cases, 77% were treated with surgery, 6.2% received chemotherapy and 3.6% received radiotherapy, with the remainder treated with best supportive care. Overall 1-year and 3-year survival rates for PC were 92% and 84.7%, respectively. In contrast, 1-year and 3-year survival rates for NSCLC were 36.2% and 15.6%, However, 3-year survival for PC markedly decreased with worsening performance status and advanced disease to 23.8% for performance status ECOG 3–4 and 33.6% for stage IV disease. Conclusions In contrast to other forms of NSCLC, the majority of patients with PC present with good performance status, preserved lung function and early stage disease amenable to surgical resection. However, 1 in 5 patients with PC has metastatic disease which is associated with poor prognosis, as is poor performance status at presentation. We believe these data will help clinicians provide accurate prognostic predictions stratified according to patient characteristics at presentation, as

  8. Endoscopic ultrasound-guided ethanol ablation of a large metastatic carcinoid tumor: success with a note of caution.

    PubMed

    Mathers, Bradley W; Harvey, Harold A; Dye, Charles E; Dougherty-Hamod, Brandy; Moyer, Matthew T

    2014-12-01

    Endoscopic ultrasonography with fine needle infusion (EUS-FNI) of alcohol is the most reported method for EUS-guided tumor ablation. Several studies have reported successful EUS-guided ablation of pancreatic neuroendocrine tumors. However, these tumors have been relatively small (< 3 cm). In this report, a 50-year-old man with a metastatic carcinoid tumor with a large porta hepatis mass was referred to our clinic for EUS-guided ethanol ablation. After two separate EUS-FNI ablations, there was a 36 % reduction in tumor size (9.0 × 11.4 cm to 6.7 × 9.8 cm) with associated tumor lysis syndrome. Chromogranin A levels decreased from 460 to 132 ng/mL. The patient reported complete resolution of abdominal pain within 2 weeks, but only mild improvement in flushing and diarrhea. In conclusion, large metastatic neuroendocrine tumors can be successfully treated with EUS-guided ethanol ablation. Evidence-based guidelines are needed with regard to the appropriate volume of ethanol injected in EUS-guided ablation to promote the efficacy and safety of this emerging procedure. PMID:26135103

  9. The experience of a referral centre and literature overview of GIST and carcinoid tumours in inflammatory bowel diseases.

    PubMed

    Pellino, Gianluca; Marcellinaro, Rosa; Candilio, Giuseppe; De Fatico, G Serena; Guadagno, Elia; Campione, Severo; Santangelo, Giuseppe; Reginelli, Alfonso; Sciaudone, Guido; Riegler, Gabriele; Canonico, Silvestro; Selvaggi, Francesco

    2016-04-01

    Patients suffering from Inflammatory Bowel Diseases (IBD) are at increased risk of developing cancers of the gastrointestinal tract (GI). Adenocarcinomas are the most commonly observed GI tumours in IBD, and occur through an in inflammation-driven pathway. A trend toward reduced risk of bowel cancers has been observed in IBD in recent years, presumably related to improved medical treatments. However, some cancers may be independent from active inflammation, probably originating from altered interactions between the extremely active immune system of IBD patients and environmental factors. Data concerning gastrointestinal stromal tumours (GIST) and carcinoids tumours (CaT) of the GI in IBD patients are scanty. We report our experience with these rare cancers, and provide the readers with an overview on the topic, focussing on distinguishing and peculiar features of GIST and CaT of the GI in IBD compared with other cancer types and with general population, and address the treatment of such challenging conditions. Available data do not support an increased risk of GIST in IBD patients, but GI CaT may be more commonly observed in Crohn's disease. However, the presentation of GIST and GI CaT is protean and does not seem to be associated with disease activity in the involved GI segment in IBD. Conversely, some evidences suggest a potential role of inflammation in sustaining GI CaT in IBD. Increased awareness, longer duration of disease, and improved diagnostic modalities should also be considered when evaluating the increasing trend of CaT in CD patients. Treatment of GIST and CaT is not dissimilar from that of non-IBD patients, but prompt suspicion and diagnosis are crucial to achieve optimal outcomes.

  10. Occupational risk factors for small bowel carcinoid tumor: a European population-based case-control study.

    PubMed

    Kaerlev, Linda; Teglbjaerg, Peter Stubbe; Sabroe, Svend; Kolstad, Henrik A; Ahrens, Wolfgang; Eriksson, Mikael; Guénel, Pascal; Hardell, Lennart; Cyr, Diane; Ballard, Terri; Zambon, Paola; Morales Suárez-Varela, María M; Stang, Andreas; Olsen, Jorn

    2002-06-01

    Small bowel carcinoid tumor (SBC) is a rare disease of unknown etiology but with an age-, sex-, and place-specific occurrence that may indicate an occupational origin. A European multicenter population-based case-control study was conducted from 1995 through 1997. Incident SBC cases between 35 and 69 years of age (n = 101) were identified, together with 3335 controls sampled from the catchment area of the cases. Histological review performed by a reference pathologist left 99 cases for study; 84 cases and 2070 population controls were interviewed. The industries most closely associated (a twofold or more odds ratio [OR]) with SBC, taking into account a 10-year time lag after exposure were, among women, employment in wholesale industry of food and beverages (OR, 8.2; 95% confidence interval [CI], 1.9 to 34.9]) and among men, manufacture of motor vehicle bodies (OR, 5.2; 95% CI, 1.2 to 22.4), footwear (OR, 3.9; 95% CI, 0.9 to 16.1), and metal structures (OR, 3.3; 95% CI, 1.0 to 10.4). The identified high-risk occupations with an OR above 2 were shoemakers, structural metal preparers, construction painters and other construction workers, bookkeepers, machine fitters, and welders (men). The OR for regular occupational use of organic solvents for at least half a year was 2.0 (95% CI, 1.0 to 4.2). Exposure to rust-preventive paint containing lead was suggested as another potential occupational exposure (OR, 9.1; 95% CI, 0.8 to 107). This explorative study suggests an association between certain occupational exposures and SBC, but some of these associations could be attributable to chance. All findings should be regarded as tentative.

  11. ECL-cell carcinoids and carcinoma in patients homozygous for an inactivating mutation in the gastric H(+) K(+) ATPase alpha subunit.

    PubMed

    Fossmark, Reidar; Calvete, Oriol; Mjønes, Patricia; Benitez, Javier; Waldum, Helge L

    2016-07-01

    A family with a missense variant of the ATP4A gene encoding the alpha subunit of the gastric proton pump (H(+) K(+) ATPase) has recently been described. Homozygous siblings were hypergastrinemic (median gastrin 486 pM) and had gastric tumours diagnosed at a median age of 33 years. In the current histopathological study, we further characterized the tumours found in the gastric corpus. The tumours had the histological appearance of carcinoids (NET G1 or G2) and were immunoreactive for the general neuroendocrine markers chromogranin A (CgA) and synaptophysin as well as the ECL-cell markers vesicular monoamine transporter 2 (VMAT2) and histidine decarbozylase (HDC). One of the tumours consisted of a NET G2 component, but also had a component with glandular growth, which morphologically was classified as an intestinal type adenocarcinoma. Many glands of the adenocarcinoma contained a large proportion of cells positive for neuroendocrine markers, especially the small vesicle marker synaptophysin and the cytoplasmic enzyme HDC. In conclusion, patients homozygous for an inactivating ATP4A mutation develop gastric ECL-cell carcinoids in their 3rd or 4th decade. The adenocarcinoma may be classified as neuroendocrine with ECL-cell differentiation. PMID:27150581

  12. Adenocarcinoma ex-goblet cell carcinoid (appendiceal-type crypt cell adenocarcinoma) is a morphologically distinct entity with highly aggressive behavior and frequent association with peritoneal/intra-abdominal dissemination: an analysis of 77 cases.

    PubMed

    Reid, Michelle D; Basturk, Olca; Shaib, Walid L; Xue, Yue; Balci, Serdar; Choi, Hye-Jeong; Akkas, Gizem; Memis, Bahar; Robinson, Brian S; El-Rayes, Bassel F; Staley, Charles A; Staley, Christopher A; Winer, Joshua H; Russell, Maria C; Knight, Jessica H; Goodman, Michael; Krasinskas, Alyssa M; Adsay, Volkan

    2016-10-01

    High-grade versions of appendiceal goblet cell carcinoids ('adenocarcinoma ex-goblet cell carcinoids') are poorly characterized. We herein document 77 examples. Tumors occurred predominantly in females (74%), mean age 55 years (29-84), most with disseminated abdominal (77% peritoneal, 58% gynecologic tract involvement) and stage IV (65%) disease. Many presented to gynecologic oncologists, and nine had a working diagnosis of ovarian carcinoma. Metastases to liver (n=3) and lung (n=1) were uncommon and none arose in adenomatous lesions. Tumors had various histologic patterns, in variable combinations, most of which were fairly specific, making them recognizable as appendiceal in origin, even at metastatic sites: I: Ordinary goblet cell carcinoid/crypt pattern (rounded, non-luminal acini with well-oriented goblet cells), in variable amounts in all cases. II: Poorly cohesive goblet cell pattern (diffusely infiltrative cords/single files of signet ring-like/goblet cells). III: Poorly cohesive non-mucinous cell (diffuse-infiltrative growth of non-mucinous cells). IV: Microglandular (rosette-like glandular) pattern without goblet cells. V: Mixed 'other' carcinoma foci (including ordinary intestinal/mucinous). VI: goblet cell carcinoid pattern with high-grade morphology (marked nuclear atypia). VII: Solid sheet-like pattern punctuated by goblet cells/microglandular units. Ordinary nested/trabecular ('carcinoid pattern') was very uncommon. In total, 33(52%) died of disease, with median overall survival 38 months and 5-year survival 32%. On multivariate analysis perineural invasion and younger age (<55) were independently associated with worse outcome while lymph-vascular invasion, stage, and nodal status trended toward, but failed to reach, statistical significance. Worse behavior in younger patients combined with female predilection and ovarian-affinity raise the possibility of hormone-assisted tumor progression. In conclusion, 'adenocarcinoma ex-goblet cell carcinoid' is

  13. Reduced uncertainty as a diagnostic benefit: an initial assessment of somatostatic receptor scintigraphy's value in detecting distant metastases of carcinoid liver tumours.

    PubMed

    Woodward, R S; Schnitzler, M A; Kvols, L K

    1998-03-01

    This paper employs classical concepts of diminishing marginal utility to demonstrate that risk-aversion can increase the perceived value of diagnostic procedures and thus raise optimum diagnostic expenditures. The theory is applied to a model in the spirit of Phelps and Mushlin's initial technology assessments. The specific evaluation is the cost-effectiveness of somatostatin receptor scintigraphy used to detect distant metastases of carcinoid liver tumours in a patient otherwise eligible for surgical resection of the liver. Data for the model are taken from published sources and financial databases, when available, and otherwise from a senior clinician's experience (LKK). The quantitative results indicate that receptor scintigraphy may have two beneficial impacts to risk-neutral individuals. First, it may reduce the combined costs of therapy and treatment because the diagnostic procedure costs less than the expected savings generated by avoiding inappropriate surgeries. Second, it may improve the patient's expected health-status-adjusted life years (HSALY) because the information allows physicians to better match treatment to the cancer's stage. Finally the paper demonstrates that risk aversion, as embodied in classical diminishing marginal utility applied to health status, can increase the value of the diagnostic tests and can lead the patient to choose a less beneficial treatment. An illustrative risk-averse utility function changed the optimum treatment from surgery to chemotherapy and increased scintigraphy's benefit by 500%. PMID:9565171

  14. Foraminotomia cervical posterior en el tratamiento de conflictos foraminales

    PubMed Central

    Campero, Álvaro; Barrera, Ramiro; Ajler, Pablo

    2012-01-01

    Introducción: La foraminomotima cervical posterior es un procedimiento utilizado para la descompresion radicular por via posterior y constituye una alternativa a la via clásica anterior. En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de 2008 a diciembre de 2011, 17 pacientes (18 foraminotomías) fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior. Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Los parámetros para valorar los resultados fueron la Escala Análoga del Dolor (VAS), la Neck Disability Index y los criterios de Odom. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante. El nivel más afectado fue C5-C6. La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8.8 (mínimo 8 – máximo 10), con una franca mejoría en todos los casos (0.4 en el último control). La media en la Neck Disability Index al inicio fue de 35.3 (mínimo 32 – máximo 45), con una evolución favorable en la evaluación final (0.6). Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1.17. Se observaron complicaciones en 4 pacientes (23%), todas tuvieron una evolución favorable. No hubo infecciones, discitis ni empeoramiento de los síntomas preexistentes en ningún paciente. Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID:23596556

  15. El uso de la neuromodulación para el tratamiento del temblor

    PubMed Central

    Bendersky, Damián; Ajler, Pablo; Yampolsky, Claudio

    2014-01-01

    Introducción: El temblor puede ser un desorden incapacitante y el tratamiento de primera línea para estos pacientes es farmacológico. Sin embargo, este tratamiento puede llevar a una reducción satisfactoria del temblor en sólo el 50% de los pacientes con temblor esencial. La talamotomía era el tratamiento de elección para el temblor refractario al tratamiento médico hasta que comenzó a utilizarse la estimulación cerebral profunda (ECP) del núcleo ventral intermedio (Vim) del tálamo. En la actualidad, raramente se realiza la talamotomía. Métodos: Este artículo es una revisión no sistemática de las indicaciones, resultados, parámetros de programación y técnica quirúrgica de la ECP del Vim para el tratamiento del temblor. Resultados: Aunque los resultados clínicos son similares usando la talamotomía o la ECP del Vim, la primera causa más efectos adversos que la última. Además, la ECP puede ser usada bilateralmente, mientras que la talamotomía tiene un alto riesgo de causar disartria cuando se realiza de ambos lados. La ECP del Vim logró una adecuada mejoría del temblor en varias series de pacientes con temblor causado por temblor esencial, enfermedad de Parkinson o esclerosis múltiple. Además del Vim, hay otros blancos que están siendo usados por varios autores, tales como la zona incerta y las radiaciones prelemniscales. Conclusión: La ECP del Vim es un tratamiento útil para el temblor incapacitante refractario al tratamiento médico. Es esencial realizar una precisa selección de pacientes, así como utilizar una técnica quirúrgica correcta. Aún se desconoce el mejor blanco estereotáctico para el temblor, aunque el Vim es el más usado. PMID:25165613

  16. Carcinoid Tumor: Frequently Asked Questions

    MedlinePlus

    ... Similarly, periodic audiograms and checks of the patients vestibular function will prevent irreversible 8th nerve damage. Monitoring ... Similarly, periodic audiograms and checks of the patients vestibular function will prevent irreversible 8th nerve damage. Monitoring ...

  17. What Are Lung Carcinoid Tumors?

    MedlinePlus

    ... the inhaled air into your bloodstream and pass carbon dioxide (a waste product from the body) into the ... exhale. Taking in oxygen and getting rid of carbon dioxide are your lungs’ main functions. A thin lining ...

  18. Un nuevo fármaco puede ser una opción de tratamiento para algunos cánceres de mama

    Cancer.gov

    Los resultados de un estudio clínico internacional permiten suponer que, en poco tiempo, habrá otra opción de tratamiento para las mujeres con cáncer de mama metastásico HER2 positivo que deja de responder a los tratamientos dirigidos con trastuzumab.

  19. Fumar durante el tratamiento de cáncer (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca de la influencia de seguir fumando sobre el tratamiento del cáncer y el riesgo de segundos cánceres. Se mencionan las intervenciones que estimulan dejar el hábito de fumar.

  20. Tratamiento ayuda a mujeres jóvenes a preservar fertilidad durante quimioterapia para cáncer de seno

    Cancer.gov

    Las mujeres jóvenes con cáncer de seno (mama) lograron preservar la fertilidad durante los tratamientos del cáncer con un fármaco inyectable bloqueador de hormonas que les provocó menopausia temporal. Los resultados del estudio se anunciaron hoy en el con

  1. Fumar durante el tratamiento de cáncer (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca de la influencia de seguir fumando sobre el tratamiento del cáncer y el riesgo de segundos cánceres. Se mencionan las intervenciones que estimulan dejar el hábito de fumar.

  2. ACT-asthma control y tratamiento para niños: a progress report.

    PubMed

    Lewis, M A; de la Sota, A; Rachelefsky, G; Lewis, C E; Quinones, H; Richards, W

    1987-01-01

    A randomized clinical trial is in progress to evaluate an asthma educational program for Latino children and their parents. The intervention, "ACT-Asma Control y Tratamiento Para Niños," was adapted from ACT for Kids, an asthma self-management program for English-speaking families. Results of a pilot study indicated that socioeconomic status was a critical variable to be considered in the design of such programs. Latino children and parents encounter significant barriers to access and continuity of medical care. Therefore, the intervention was redesigned to include "linkages" using a nurse to reduce barriers and to coordinate care. The lesson plans emphasize concrete, experimental learning experiences, with repetition of key points in each session. PMID:3654235

  3. Metastatic Midgut Carcinoid in the Myocardium.

    PubMed

    Bukowczan, Jakub; Lois, Konstantinos B; Skinner, Jane; Petrides, George; James, Robert Andrew; Perros, Petros

    2015-09-01

    Metastasis of neuroendocrine tumor to the myocardium is rare. We present a case of 64-year-old woman, who presented initially with abdominal pain and large adnexal mass. The image-guided biopsy showed low-grade neuroendocrine tumor with Ki67 less than 2% within the ovarian tissue. CT staging revealed bilateral adnexal masses, liver metastases, and primary lesion in the terminal ileum. Octreoscan showed marked tracer uptake within the lower esophagus not related to obvious mass on CT scan; the echocardiography confirmed the presence of a 2.7 cm LV/LA mass. In this case, close correlation between ECHO and the octreoscan obviated need for myocardial biopsy. PMID:26164175

  4. How Are Gastrointestinal Carcinoid Tumors Diagnosed?

    MedlinePlus

    ... as symptoms that might be caused by a mass (tumor) in the stomach, intestines, or rectum. Some ... attention to the abdomen, looking for a tumor mass or enlarged liver. If your medical history and ...

  5. How Are Lung Carcinoid Tumors Staged?

    MedlinePlus

    ... from the abdomen (diaphragm), the membranes surrounding the space between the lungs (mediastinal pleura), or membranes of ... tumor of any size has grown into the space between the lungs (mediastinum), the heart, the large ...

  6. What Is a Gastrointestinal Carcinoid Tumor?

    MedlinePlus

    ... for energy and rids the body of solid waste. After food is chewed and swallowed, it enters the esophagus. ... The colon absorbs water and mineral nutrients from food and serves as a storage place for waste. The waste left after this process goes into ...

  7. Nueva opción de tratamiento para mujeres jóvenes con cáncer de seno sensible a las hormonas

    Cancer.gov

    Un fármaco usado para el tratamiento del cáncer de seno (mama), conocido como exemestano, es más eficaz que tamoxifeno, un fármaco preventivo de uso común para el cáncer de seno, en la prevención de la recidiva del cáncer de seno en mujeres jóvenes que ta

  8. Extensión del Formalismo de Orbitales de Defecto Cuántico al tratamiento del efecto Stark (SQDO).

    NASA Astrophysics Data System (ADS)

    Menéndez, J. M.; Martín, I.; Velasco, A. M.

    El estudio experimental de las interacciones de átomos Rydberg altamente excitados con campos eléctricos ha experimentado un creciente interés durante las dos últimas décadas debido, en gran medida, al desarrollo de nuevas técnicas para crear y estudiar átomos Rydberg en el laboratorio. Acompañando a estas nuevas técnicas experimentales, es necesario el desarrollo de modelos teóricos que nos permitan contrastar sus medidas y conocer mejor los fundamentos de los mismos. Desde el punto de vista teórico el conocimiento del desdoblamiento de los niveles energéticos de un átomo en función de la magnitud del campo eléctrico aplicado (lo que se conoce como mapa Stark) es el mejor punto de partida para la descripción del sistema y un prerrequisito fundamental para el cálculo de distintas propiedades atómicas en presencia del campo eléctrico tales como intensidades de transición, umbrales de ionización de campo eléctrico, tiempos de vida, posición y anchura de cruces evitados, etc. En este trabajo presentamos la adaptación del método de orbitales de defecto cuántico [1,2,3] al tratamiento del efecto Stark (SQDO) [4] y su aplicación al cálculo de los desdoblamientos energéticos y fuerzas de oscilador de estados Rydberg en los átomos de Li, Na y K. El propósito de este estudio es, por un lado, desarrollar métodos fiables para la determinación de propiedades atómicas en presencia de campos eléctricos y, por otro, mostrar la fiabilidad de las funciones de onda QDO en la descripción del efecto Stark en sistemas atómicos.

  9. [Prevalence of gastrointestinal disorders in adults with common variable immunodeficiency at Specialty Hospital Dr. Bernardo Sepulveda].

    PubMed

    Rodríguez-Negrete, Elda Victoria; Mayoral-Zavala, Arturo; Rodríguez-Mireles, Karen Alicia; Díaz de León-Salazar, Oscar Edmundo; Hernández-Mondragón, Oscar; Gómez-Jiménez, Luz María; Moreno-Alcántar, R; González-Virla, Baldomero

    2015-01-01

    Antecedentes: la incidencia de la inmunodeficiencia común variable (IDCV) es de 1 por cada 15,000 a 117,000 casos, sin predominio de género. La incidencia de manifestaciones gastrointestinales en estos pacientes es de 20 a 60% y pueden ser la primera y única manifestación clínica de IDCV. En México existe escasa información en relación con el tipo y frecuencia de alteraciones gastrointestinales que padecen los pacientes adultos con IDCV. Objetivo: determinar la prevalencia de alteraciones gastrointestinales en pacientes adultos con inmunodeficiencia común variable. Material y método: estudio descriptivo, observacional y transversal en el que participaron pacientes con inmunodeficiencia común variable de la Clínica de Inmunodeficiencias del Servicio de Alergia e Inmunología Clínica del Hospital de Especialidades, Centro Médico Nacional Siglo XXI. A todos los pacientes se les aplicó un cuestionario de síntomas gastrointestinales y se les realizaron estudios de laboratorio, gabinete, endoscopia y prueba de aliento para determinar sobrepoblación bacteriana. Resultados: evaluamos 17 pacientes, 8 hombres y 9 mujeres, con edad promedio de 36 años y diagnóstico definitivo de inmunodeficiencia común variable de acuerdo con criterios internacionales. El 59% refirió dolor abdominal, 53% distensión abdominal y 17.6% estreñimiento. El 47% tenía diarrea crónica, en dos de ellos (11.8%) acompañada de pujo rectal. Las enfermedades gastrointestinales de esta población fueron: 18% diarrea crónica, enfermedad celiaca y sobrepoblación bacteriana, 24% trastorno funcional digestivo, 12% estreñimiento, 6% dispepsia. Sólo un paciente (6%) no tenía síntomas gastrointestinales. Conclusión: la prevalencia de las enfermedades gastrointestinales en pacientes adultos con inmunodeficiencia común variable fue de 94%, sin predominio de género. Debido a la frecuencia de manifestaciones gastrointestinales, es importante realizar protocolos de estudio al respecto

  10. Nuevas estrategias de gestión, tratamiento y valorización de los efluentes organicos pecuarios: Experiencias en USDA. (Management strategies for organic livestock effluents,innovative treatment and valorization)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    En la actualidad el impacto potencial de los residuos ganaderos en el medio-ambiente representa uno de los desafíos más grandes de la agricultura. Las tecnologías de tratamiento pueden tener un importante papel en el manejo de los residuos ganaderos dando más flexibilidad en los programas de la apli...

  11. Romidepsin in Treating Patients With Locally Advanced or Metastatic Neuroendocrine Tumors

    ClinicalTrials.gov

    2013-06-03

    Gastrinoma; Glucagonoma; Insulinoma; Metastatic Gastrointestinal Carcinoid Tumor; Pancreatic Polypeptide Tumor; Pulmonary Carcinoid Tumor; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Regional Gastrointestinal Carcinoid Tumor; Somatostatinoma

  12. Prognostic factors in multiple myeloma: definition of risk groups in 410 previously untreated patients: a Grupo Argentino de Tratamiento de la Leucemia Aguda study.

    PubMed

    Corrado, C; Santarelli, M T; Pavlovsky, S; Pizzolato, M

    1989-12-01

    Four hundred ten previously untreated multiple myeloma patients entered onto two consecutive Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) protocols were analyzed to identify significant prognostic factors influencing survival. The univariate analysis selected the following variables: performance status, renal function, percentage of bone marrow plasma cells at diagnosis, hemoglobin, and age. A multivariate analysis showed that performance status, renal function, percentage of bone marrow plasma cells, hemoglobin, and age were the best predictive variables for survival. A score was assigned to each patient according to these variables, which led to their classification in three groups: good, intermediate, and poor risk, with a probability of survival of 26% and 10% at 96 months, and 5% at 56 months, and median survival of 60, 37, and 14 months, respectively (P = .0000). In our patient population, this model proved to be superior to the Durie-Salmon staging system in defining prognostic risk groups, and separating patients with significantly different risks within each Durie-Salmon stage.

  13. Central bronchial carcinoid: Management of a case and anesthetic perspectives.

    PubMed

    Goswami, D; Kashyap, L; Batra, R K; Bhagat, C

    2016-01-01

    Obstructing lesions of the central airways present with a variety of symptoms and are often associated with pneumonia or asthma-like states. Anesthesia to these patients often presents challenges right from the preoperative stabilization of underlying lung condition, mask ventilation in the supine position to maintaining oxygenation and ventilation in the intraoperative and postoperative period. We present here a case of a young woman with a central bronchial tumor with significant airway obstruction with potential for major bleeding and subsequent anesthetic management without lung sacrificing measures and cardiopulmonary bypass assistance. PMID:26955320

  14. Surgical approaches for liver metastases in carcinoid tumors

    PubMed Central

    Saeed, Ahmad; Buell, Joseph

    2015-01-01

    Liver is the commonest site for metastasis in patients with neuroendocrine tumors (NETs); it occurs in 45-95% of patients. Available treatment options include surgical resection, liver transplantation, chemotherapy and biotherapy. Surgery is the gold standard for curative therapy. Typically, a multidisciplinary approach is a cornerstone for decision making while dealing with this aggressive disease. This review will focus on the performance and safety of open, laparoscopic, and liver transplant surgical approaches in NETs patients with liver metastases. PMID:26425458

  15. Tratamiento Quirúrgico de los Meningiomas del Foramen Óptico, Técnicay Resultados de una Serie de 18 Pacientes

    PubMed Central

    Goldschmidt, Ezequiel; Ajler, Pablo; Campero, Álvaro; Landriel, Federico; Sposito, Maximiliano; Carrizo, Antonio

    2014-01-01

    Introducción: los meningiomas del foramen óptico producen un rápido deterioro de la función visual aún cuando su tamaño es pequeño, por eso su diagnóstico y manejo difiere del resto de los meningiomas clinoideos. El propósito de este estudio es presentar la técnica y los resultados de nuestro manejo quirúrgico de meningiomas foraminales (MF). Pacientes y Métodos: se llevó a cabo una revisión de las historias clínicas de 47 pacientes con meningiomas primarios intraorbitarios. Se realizaron 52 cirugías en los pacientes con MF. Se empleó una craneotomía fronto-orbitaria, seguida de una descompresión extradural del canal óptico, resección del componente intraorbitario y exploración intradural del nervio óptico. Resultados: de los 12 pacientes con MF que presentaban la visión conservada, la agudeza visual fue preservada en 7 casos, mejoró en 2, y empeoró en 3. En 18 pacientes, el principal síntoma fue exoftalmos y en 35 pacientes ceguera unilateral. Ocurrieron 6 recurrencias, 2 a 10 años después de la resección quirúrgica. Cinco de ellos fueron reoperados. Se indicó radioterapia después de la recurrencia en 3 pacientes. Conclusión: el manejo de los MF continúa siendo controvertido y frecuentemente se propone un tratamiento conservador. Basados en nuestros hallazgos de frecuente extensión intracraneal, proponemos realizar una resección total o subtotal del tumor, preservando el nervio óptico en pacientes con visión prequirúrgica conservada. PMID:25165616

  16. Regorafenib in Treating Patients With Advanced or Metastatic Neuroendocrine Tumors

    ClinicalTrials.gov

    2015-08-29

    Gastrinoma; Glucagonoma; Insulinoma; Metastatic Gastrointestinal Carcinoid Tumor; Pancreatic Polypeptide Tumor; Pulmonary Carcinoid Tumor; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Somatostatinoma

  17. [Pulmonary carcinoid: analysis of a single institutional experience and prognostic factors].

    PubMed

    Correia, Silvia da Silva; Pinto, Carlos; Bernardo, João

    2014-01-01

    IntroduçÉo: Os tumores carcinóides pulmonares sÉo tumores raros com origem nas células neuro-endócrinas do pulmÉo. Classificam-se de acordo com os critérios da OMS em carcinóides típicos ou atípicos. Quando comparados com outros tipos de neoplasia pulmonar, os tumores carcinóides apresentam melhor prognóstico.Objetivos: CaracterizaçÉo dos doentes com diagnóstico histológico de tumor carcinóide observados numa instituiçÉo. Análise dos fatores que influenciaram o prognóstico.Material e Métodos: Análise retrospetiva incluindo todos os doentes com diagnóstico histológico de tumor carcinóide pulmonar durante um período de 11 anos numa instituiçÉo. Os tumores foram classificados em típicos e atípicos de acordo com a classificaçÉo da OrganizaçÉo Mundial de Saúde de 2004. O estadiamento foi feito com base na classificaçÉo TNM de 2009 para o carcinoma do pulmÉo de nÉo pequenas células: T (Tumor); N (Ganglionar); M (Metástase).Resultados: Foram incluídos 59 doentes: 53 carcinóides típicos e seis carcinóides atípicos. Destes, 90% foram submetidos a cirurgia. O follow-up médio foi de 57 meses. A mortalidade operatória foi de 2% (n = 1) tratando-se de cirurgia paliativa para um doente em estádio IV. Em 49 doentes nÉo se verificou envolvimento ganglionar (N0), um doente apresentava doença N1, oito doença N2 e um doente doença N3. A sobrevivência global aos cinco anos foi de 79,2%: 80,2% nos carcinóides típicos e 66,7% nos carcinóides atípicos (p < 0,05). Nos doentes T1, a sobrevivência foi de 88,1% e de 58,2% nos T2-T4 (p < 0,01). Nos doentes N0 a sobrevivência aos cinco anos de 89,7% e de 36% para os doentes N1-N3 (p < 0,001). Os doentes com doença M0 apresentaram uma sobrevivência aos cinco anos de 85,9% sendo de 0% nos doentes M1 (p < 0,01). Dos 11 doentes que necessitaram de quimioterapia adjuvante, 45,4% eram carcinóides atípicos.DiscussÉo: Na nossa série, a cirurgia no tumor carcinóide pulmonar demonstrou-se segura, com uma baixa taxa de complicações no pós-operatório. Observou-se pior prognóstico em doentes com tumor carcinóide atípico, tumores com mais de 3 cm, com envolvimento ganglionar ou presença de metástase. A sobrevivência aos cinco anos nos tumores carcinóides típicos foi excelente (80,2%), correspondente à encontrada na literatura. No tumor carcinóide atípico, a sobrevivência aos cinco anos foi de 66,7% também concordante com os dados obtidos em estudos anteriores.Conclusões: Os tumores carcinóides pulmonares sÉo na maioria carcinóides típicos com uma excelente sobrevivência a longoprazo. A cirurgia de ressecçÉo é o tratamento de eleiçÉo nestes doentes. Os fatores relacionados com um pior prognóstico foram o subtipo histológico (carcinóides típicos versus carcinóides atípicos), o tamanho do tumor, o envolvimento ganglionar e a presença de metástases.

  18. Perforated Meckel's diverticulum containing a carcinoid tumor successfully treated by the laparoscopic approach: Case report

    PubMed Central

    Curbelo-Peña, Yuhamy; Dardano-Berriel, Juan; Guedes-De la Puente, Xavier; Saladich-Cubero, Maria; Stickar, Tomas; De Caralt-Mestres, Enric

    2016-01-01

    Mekel's diverticulum is a gastrointestinal malformation. Occurs in one of every 40 patients. It is usually asymptomatic whereas complications can be developed in 2% to 4%. The report is based on a 41-year old male, who attended to emergency, complaining of right lower quadrant abdominal pain. Blood tests showed high level of inflammatory markers. With acute appendicitis as presumptive diagnosis, laparoscopy was performed. The intraoperative findings were: a perforated Mekel's diverticulum with normal cecal appendix. Mechanical diverticular resection was made. The patient was successfully recovered from surgery. Histopathology examination showed: Meckel's diverticulum perforated with acute inflammation and neuroendocrine tumor (G1) pT1. Mekel's diverticulum is rarely affected by inflammatory complications and just few cases are associated with tumors. However, has ever been described before, coexisting both situations, being our patient the first reported with this exceptional clinical presentation, and treated successfully by laparoscopic approach. PMID:27251847

  19. Validation of serum versus plasma measurements of chromogranin A levels in patients with carcinoid tumors.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Chromogranin A (CGA) levels are used to confirm the diagnosis, and monitor the course of patients with neuroendocrine tumors. Chromogranin A levels are significantly reduced when patients are acutely treated with octreotide; however, limited data is available that correlates octreotide long-acting ...

  20. Inflammatory myofibroblastic tumor of the lung in pregnancy mimicking carcinoid tumor.

    PubMed

    Maturu, Venkata Nagarjuna; Bal, Amanjit; Singh, Navneet

    2016-01-01

    Inflammatory myofibroblastic tumors (IMT) are uncommon neoplasms of the lung in adults. They constitute less than 1% of all lung neoplasms and usually present as parenchymal masses. Diagnosis requires a high index of suspicion. They are characterized by spindle-shaped tumor cells (fibroblasts/myofibroblasts) in a background of lymphoplasmacytic infiltrate. About 50% of the tumors harbor an ALK gene rearrangement. They have to be differentiated from inflammatory pseudotumors (IPT), which show increased number of IgG4 plasma cells on immunostaining and are negative for anaplastic lymphoma kinase (ALK) protein. Herein, we present a case of a 28-year old female who presented with hemoptysis and was diagnosed with an IMT of lung in the first trimester of pregnancy. We have not only reviewed the occurrence of IMT during pregnancy but also discuss the management options for IMT during pregnancy. PMID:26933315

  1. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs)

    PubMed Central

    Ahmed, A; Ardill, J; Bax, N; Breen, D J; Caplin, M E; Corrie, P; Davar, J; Davies, A H; Lewington, V; Meyer, T; Newell-Price, J; Poston, G; Reed, N; Rockall, A; Steward, W; Thakker, R V; Toubanakis, C; Valle, J; Verbeke, C; Grossman, A B

    2011-01-01

    These guidelines update previous guidance published in 2005. They have been revised by a group who are members of the UK and Ireland Neuroendocrine Tumour Society with endorsement from the clinical committees of the British Society of Gastroenterology, the Society for Endocrinology, the Association of Surgeons of Great Britain and Ireland (and its Surgical Specialty Associations), the British Society of Gastrointestinal and Abdominal Radiology and others. The authorship represents leaders of the various groups in the UK and Ireland Neuroendocrine Tumour Society, but a large amount of work has been carried out by other specialists, many of whom attended a guidelines conference in May 2009. We have attempted to represent this work in the acknowledgements section. Over the past few years, there have been advances in the management of neuroendocrine tumours, which have included clearer characterisation, more specific and therapeutically relevant diagnosis, and improved treatments. However, there remain few randomised trials in the field and the disease is uncommon, hence all evidence must be considered weak in comparison with other more common cancers. PMID:22052063

  2. Sorafenib Tosylate in Treating Patients With Progressive Metastatic Neuroendocrine Tumors

    ClinicalTrials.gov

    2014-11-14

    Gastrinoma; Glucagonoma; Insulinoma; Metastatic Gastrointestinal Carcinoid Tumor; Neuroendocrine Tumor; Pancreatic Polypeptide Tumor; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Somatostatinoma; WDHA Syndrome

  3. Gefitinib in Treating Patients With Progressive Metastatic Neuroendocrine Tumors

    ClinicalTrials.gov

    2013-06-03

    Gastrinoma; Glucagonoma; Insulinoma; Metastatic Gastrointestinal Carcinoid Tumor; Pancreatic Polypeptide Tumor; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Somatostatinoma; WDHA Syndrome

  4. [Fiber-type indication among different pathologies].

    PubMed

    Sánchez Almaraz, Rosalía; Martín Fuentes, María; Palma Milla, Samara; López Plaza, Bricia; Bermejo López, Laura M; Gómez Candela, Carmen

    2015-06-01

    Introducción: la fibra engloba los carbohidratos no digeridos ni absorbidos en el tubo digestivo, llegando intactos al colon. Se clasifica en soluble e insoluble, con propiedades fisiológicas distintas. La fibra se ha empleado frecuentemente para tratar y prevenir diversas patologías gastrointestinales. También se ha estudiado su papel en la fisiopatología de enfermedades como la diabetes, la dislipemia, la hipertensión arterial y la obesidad. Además se ha relacionado su consumo con la prevención de ciertos tumores, en especial del cáncer colorrectal, así como con el aumento de la excreción de nitrógeno en heces. Objetivos: analizar la evidencia del papel que la fibra puede tener en el tratamiento y prevención de distintas enfermedades, así como el tipo de fibra más adecuado en cada una. Métodos: revisión no sistemática en Medline y Pubmed, y posterior aplicación de los criterios de inclusión y exclusión. Resultados: diferentes tipos de fibra pueden ser útiles en el tratamiento de enfermedades gastrointestinales, como el estreñimiento, la diarrea, el síndrome de intestino irritable, la colitis ulcerosa en remisión o el síndrome de intestino corto. Los pacientes con diabetes, obesidad, hiperlipidemia, hipertensión y enfermedad cardiovascular también pueden beneficiarse del consumo principalmente de fibra soluble. La fibra alimentaria ha demostrado prevenir el cáncer de colon y otros tumores. En pacientes con encefalopatía hepática o insuficiencia renal, la fibra fermentable ha demostrado beneficios. Conclusiones: la fibra tiene un papel importante en la prevención y tratamiento de múltiples enfermedades; sin embargo, son necesarios más estudios de calidad para poder realizar recomendaciones más específicas.

  5. [The metoclopramide effect on enteral nutrition tolerance and mechanical ventilation associated pneumonia in neuro critically ill patients].

    PubMed

    Acosta-Escribano, Jose; Almanza López, Susana; Plumed Martín, Lidia; García Martinez, Miguel Angel; Tajadura Manjarín, Nuria

    2014-06-01

    Introducción: El uso de procinéticos en el paciente crítico con nutrición enteral, tienen como objetivo el reducir el aumento del residuo gástrico (RG). Analizamos su eficacia en la mejoría del aporte enteral y sobre la reducción en la incidencia complicaciones gastrointestinales (CGI) y neumonía, en pacientes críticos, con lesión neurológica Objetivos: Medir los efectos en la administración metoclopramida (MCG) durante los primeros cinco días con nutrición enteral, versus control (GC), sobre el volumen de dieta enteral administrada, el número de complicaciones gastrointestinales y la incidencia de neumonía asociada a ventilación mecánica (NAVM); en enfermos neurocríticos de etiología traumática y vascular. Métodos: De los 150 pacientes NC ingresados de forma consecutiva, 109 fueron aleatorizados en dos grupos: 58 MCG y 51 GC. Los objetivos primarios fueron: nutricionales: el volumen de dieta administrada (VDA), el volumen eficaz (VEM), el número de complicaciones gastrointestinales (CGI) y la tasa de suspensión temporal y definitiva de la dieta. Infecciosos: incidencia de neumonía asociada a ventilación mecánica (NAVM). Fueron objetivos secundarios: la duración de la ventilación mecánica, la estancia en UCI y hospitalaria, la secuela neurológica grave al alta y la mortalidad a los 30 días. Resultados: No se observaron diferencias en los parámetros de gravedad entre grupos al ingreso. Un incremento significativo fue observado en el análisis global y a los cinco días (p < 0,03) del VEM en el grupo de MCG. Los valores del VDA global y durante las dos fases de estudio, el número de CGI y el número de suspensiones parciales y definitivas de la dieta o el número de NAVM fueron similares en ambos grupos, no significativos. Tampoco se observaron diferencias en los diferentes objetivos secundarios Conclusión: El uso de metoclopramida en el enfermo neurocrítico, no es eficaz en la disminución de las CGI, en las dosis y tiempo de

  6. [Clinical applications of the use of probiotics in pediatrics].

    PubMed

    Álvarez-Calatayud, Guillermo; Pérez-Moreno, Jimena; Tolín, Mar; Sánchez, César

    2013-01-01

    Introducción: El empleo de probióticos supone un novedoso avance en el campo de la Pediatría puesto que pueden ser útiles en la prevención y tratamiento de múltiples patologías gastrointestinales, constituyendo un elemento más en nuestro arsenal terapéutico. Objetivo: En este artículo se presenta una revisión actualizada de la literatura científica sobre el uso de los probióticos en Pediatría, principalmente en problemas gastrointestinales con alteración en la microbiota intestinal describiéndose las principales aplicaciones del empleo de los probióticos y prebióticos en la infancia y repasando las líneas de investigación futuras. Resultados y conclusiones: A pesar de existir suficiente evidencia científica en varias patologías, la utilización de probióticos no está del todo incorporado a la práctica clínica habitual de los pediatras. Se emplea en el contexto de las enfermedades gastrointestinales (diarrea aguda infecciosa, la diarrea asociada a antibióticos, sobredesarrollo bacteriano) y, más recientemente, en procesos inflamatorios crónicos como la enfermedad inflamatoria intestinal o en trastornos funcionales como el cólico del lactante o el estreñimiento. También se ha valorado su efecto beneficioso en alteraciones extraintestinales, tales como la alergia (dermatitis atópica) o los efectos sobre las mucosas respiratorias o urogenitales y, en los últimos años, en la prevención de patología del recién nacido pretérmino y en la infección por H. pylori. Además existen varias líneas de investigación abiertas en la suplementación alimentaria con probióticos y prebióticos. Cada cepa prebiótica debe ser estudiada individualmente y extensamente para determinar su eficacia y seguridad en todas aquellas situaciones en que su empleo puede ser aconsejable.

  7. Como Lo Hago Yo: Tratamiento Quirurgico Del Mielomeningocele

    PubMed Central

    Portillo, Santiago

    2014-01-01

    En Argentina hay plan de fortificación con ácido fólico. Diagnostico prenatal no siempre es correcto. Cierre según técnica. Cerramos músculo. No favorecemos corpectomía temprana en casos de cifosis. Suturamos la plaqueta. Cerramos el plano muscular. Hidrocefalia: Válvula de derivación, generalmente dentro de los dos primeros meses. Ventriculostomía no está indicada. Chiari II. Laminectomia cervical alta. Siringomielia: Derivación desde la cavidad al peritoneo. PMID:24791219

  8. Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)

    PubMed Central

    2012-01-01

    used as a base for subsequent work related to traditional medicine and its contribution to allopathic medicine in San Pablo de Huacareta. Resumen Introducción El objetivo del presente estudio fue documentar los tipos de enfermedades tratadas mediante el uso de plantas medicinales, sus aplicaciones principales y también tener un reporte de las enfermedades mayormente atendidas en el Hospital de San Pablo de Huacareta (Chuquisaca, Bolivia). Métodos Se realizaron encuestas semiestructuradas a 10 informantes locales anotando los usos atribuidos a sus plantas medicinales, se agruparon las plantas por categorías de enfermedades tratadas en la medicina tradicional. Se obtuvieron reportes de casos tratados en el Hospital de Huacareta para poder relacionar el tratamiento de enfermedades recurrentes en la zona entre la medicina tradicional y la medicina occidental. Resultados Se reportaron 91 especies nativas y exóticas, además de un espécimen indeterminado exótico que intervienen en un total de 258 aplicaciones medicinales, las cuales son empleadas en un total de 13 categorías de enfermedades. Los desórdenes gastrointestinales (55%) son mayormente tratados mediante plantas medicinales, seguidas de las afecciones al sistema esqueleto-muscular (25%) y enfermedades dermatológicas (24%). La información del Hospital indica que las enfermedades más frecuentes son Infecciones Respiratorias Agudas (47%) y Enfermedades Diarreicas Agudas (37%). Los remedios vegetales se emplean en forma de infusiones y cocciones principalmente. Se emplean mayormente plantas nativas, también se introdujo en la farmacopea médica el uso de plantas exóticas al lugar. Conclusiones El tratamiento de trastornos gastrointestinales constituye el objetivo primordial de la etnobotánica médica de los habitantes de Huacareta, las enfermedades del sistema respiratorio, son mayormente tratadas en el Hospital. Observando los datos del libro de consultas del Hospital, se puede inferir que los des

  9. [Use of intravenous immunoglobulin in pregnancy. Report of a patient with common variable immunodeficiency].

    PubMed

    Cambray-Gutiérrez, Julio César; García-Ramírez, Ulises Noel; Del Rivero-Hernández, Leonel Gerardo; López-Pérez, Patricia; Chávez-García, Aurora

    2016-01-01

    Antecedentes: La inmunodeficiencia común variable es la inmunodeficiencia primaria más diagnosticada en los adultos; se caracteriza por infecciones sinopulmonares y gastrointestinales de repetición y mayor incidencia de procesos autoinmunes y malignidad. Numerosos pacientes inician con las manifestaciones clínicas durante la edad reproductiva. Caso clínico: Mujer de 34 años de edad con 12 semanas de gestación, en quien se diagnosticó inmunodeficiencia común variable después de cuadros recurrentes de rinosinusitis, faringoadmidalitis y neumonías. Durante el segundo trimestre se prescribió 0.6 g/kg de inmunoglobulina intravenosa cada 21 días; la paciente solo presentó un episodio de faringoamigdalitis, con adecuada respuesta al tratamiento con antibióticos. Durante el tercer trimestre se ajustó la dosis a cada 14 días. La paciente concluyó el embarazo a término sin complicaciones, con producto sin malformaciones y con peso y talla adecuados. Conclusiones: La administración de inmunoglobulina es el principal tratamiento para controlar la inmunodeficiencia común variable. Si bien la dosis inicial recomendada es de 400-800 mg/kg en forma intravenosa cada 3 a 4 semanas, no existe un consenso sobre la dosis que debe emplearse en la mujer que cursa con embarazo. La recomendación es realizar controles de niveles séricos antes de la infusión para determinarla y ajustarla.

  10. MIBG scintiscan

    MedlinePlus

    Adrenal medullary imaging; Meta-iodobenzylguanidine scintiscan; Pheochromocytoma - MIBG; Neuroblastoma - MIBG; Carcinoid MIBG ... answer. It is also used to help diagnose neuroblastoma and can be used for carcinoid tumors.

  11. [GASTROSTOMY POSITIVELY AFFECTS NUTRITIONAL STATUS AND DIMINISHES HOSPITAL DAYS IN PATIENTS WITH INBORN ERRORS OF METABOLISM].

    PubMed

    Guillén-López, Sara; Vela-Amieva, Marcela; Juárez-Cruz, Merit Valeria; González-Zamora, José Francisco; Monroy-Santoyo, Susana; Belmont-Martínez, Leticia

    2015-07-01

    Introducción: el tratamiento nutricional de los pacientes con errores innatos del metabolismo (EIM) implica el uso permanente de fórmulas modificadas en aminoácidos cuyas características organolépticas pueden dificultar su aceptación por vía oral. Estos pacientes pueden tener alteraciones gastrointestinales y requieren el uso constante de medicamentos, lo cual complica la adherencia al tratamiento, comprometiéndose con ello su estado nutricional y el control de la enfermedad. La gastrostomía es una alternativa para facilitar la alimentación y el tratamiento, pero existen controversias sobre su uso. Objetivo: comparar el estado nutricional y la duración de las hospitalizaciones antes y después de la realización de la gastrostomía en un grupo de pacientes con EIM. Métodos: análisis retrospectivo de datos antropométricos, número de internamientos por descompensación metabólica y su duración en pacientes pediátricos con EIM antes y después de la gastrostomía. Resultados: se analizaron 16 niños; 40% con defectos del propionato, 25% con alteraciones del ciclo de la urea y 35% con otros EIM. Después de la gastrostomía, la proporción de pacientes eutróficos aumentó del 6 al 56% y la desnutrición disminuyó del 94 al 44%. Después de la gastrostomía, la duración de los periodos hospitalarios disminuyó significativamente de 425 a 131 días (p = 0.011); el número de internamientos disminuyó de 33 antes de la intervención a 17, sin embargo, esta diferencia no tuvo significación estadística. Conclusión: en esta muestra, la gastrostomía mejoró el estado nutricional en 56% de los pacientes con EIM, y redujo significativamente los días de hospitalización por descompensación metabólica.

  12. [Simplified laparoscopic gastric bypass. Initial experience].

    PubMed

    Hernández-Miguelena, Luis; Maldonado-Vázquez, Angélica; Cortes-Romano, Pablo; Ríos-Cruz, Daniel; Marín-Domínguez, Raúl; Castillo-González, Armando

    2014-01-01

    Antecedentes: la cirugía de la obesidad comprende diversos procedimientos gastrointestinales. El bypass gástrico en Y de Roux es el prototipo de los procedimientos mixtos y el más practicado en el mundo en sus diversas variedades. Una técnica similar y novedosa es la adoptada por Cardoso-Ramos y Galvao denominada "bypass simplificado" que rápidamente se aceptó por la mayor facilidad y resultados muy parecidos a la técnica convencional. Objetivo: describir los resultados a un año del bypass gástrico simplificado para el tratamiento de la obesidad mórbida. Material y métodos: estudio retrospectivo y descriptivo de todos los pacientes a quienes se realizó bypass gástrico de enero de 2008 a julio de 2012, en la clínica de obesidad de un hospital privado de la Ciudad de México. Resultados: se estudiaron 90 pacientes con diagnóstico de obesidad mórbida, con límites de edad de 18 y 65 años, operados para bypass gástrico simplificado. En 10% de los pacientes hubo complicaciones, las más frecuentes fueron: hemorragia y hernia interna. Durante el periodo de estudio la mortalidad fue de 0%. La pérdida de peso promedio a los 12 meses fue de 72.7%. Conclusión: el bypass gástrico simplificado laparoscópico es una cirugía segura, con buenos resultados a mediano plazo, y con una pérdida del exceso de peso adecuada en 71% de los casos.

  13. Tratamiento del cáncer sin daño al corazón

    Cancer.gov

    Investigadores de los campos de oncología y de cardiología están trabajando para encontrar formas de impedir, manejar y posiblemente aun revertir los efectos secundarios cardiovasculares de ciertas terapias del cáncer.

  14. Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)

    PubMed Central

    2012-01-01

    used as a base for subsequent work related to traditional medicine and its contribution to allopathic medicine in San Pablo de Huacareta. Resumen Introducción El objetivo del presente estudio fue documentar los tipos de enfermedades tratadas mediante el uso de plantas medicinales, sus aplicaciones principales y también tener un reporte de las enfermedades mayormente atendidas en el Hospital de San Pablo de Huacareta (Chuquisaca, Bolivia). Métodos Se realizaron encuestas semiestructuradas a 10 informantes locales anotando los usos atribuidos a sus plantas medicinales, se agruparon las plantas por categorías de enfermedades tratadas en la medicina tradicional. Se obtuvieron reportes de casos tratados en el Hospital de Huacareta para poder relacionar el tratamiento de enfermedades recurrentes en la zona entre la medicina tradicional y la medicina occidental. Resultados Se reportaron 91 especies nativas y exóticas, además de un espécimen indeterminado exótico que intervienen en un total de 258 aplicaciones medicinales, las cuales son empleadas en un total de 13 categorías de enfermedades. Los desórdenes gastrointestinales (55%) son mayormente tratados mediante plantas medicinales, seguidas de las afecciones al sistema esqueleto-muscular (25%) y enfermedades dermatológicas (24%). La información del Hospital indica que las enfermedades más frecuentes son Infecciones Respiratorias Agudas (47%) y Enfermedades Diarreicas Agudas (37%). Los remedios vegetales se emplean en forma de infusiones y cocciones principalmente. Se emplean mayormente plantas nativas, también se introdujo en la farmacopea médica el uso de plantas exóticas al lugar. Conclusiones El tratamiento de trastornos gastrointestinales constituye el objetivo primordial de la etnobotánica médica de los habitantes de Huacareta, las enfermedades del sistema respiratorio, son mayormente tratadas en el Hospital. Observando los datos del libro de consultas del Hospital, se puede inferir que los des

  15. Possible photoactivated dermatitis with features of post-inflammatory pigmentary alteration (PIPA) and rosacea.

    PubMed

    Orme, Charisse M; Shvartsbeyn, Marianna; Meehan, Shane A; Kornreich, Craig; Ramachandran, Sarika; Soter, Nicholas A

    2015-12-16

    Cutaneous flushing and facial erythema are common dermatologic conditions that elicit a wide differential diagnosis that includes rosacea, seborrheic dermatitis, photodermatitis, connective-tissue diseases, carcinoid syndrome, and mastocytosis. Herein we present an usual case of a mask-like rosacea-PIPA overlap that occurred in a patient with prior history of rectal carcinoid tumor and a negative systemic evaluation.

  16. La espiritualidad en el tratamiento del cáncer (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca de la influencia que tiene la espiritualidad y la religión en las personas que tienen cáncer. Se discuten varios métodos sobre manejo e intervención.

  17. Innovative manure treatments in the USA – state of the art (Tratamientos Innovadores de estiercoles en USA - estado del arte)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Currently, the potential impact of manure on the environment represents one of the world agriculture’s major challenges. Treatment technologies can play an important role in the management of livestock manure by providing a more flexible approach to land application and acreage limitations and by so...

  18. La espiritualidad en el tratamiento del cáncer (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca de la influencia que tiene la espiritualidad y la religión en las personas que tienen cáncer. Se discuten varios métodos sobre manejo e intervención.

  19. Hacia una adaptación cultural para el tratamiento de trastornos alimentarios en latinos en Estados Unidos

    PubMed Central

    Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M.

    2011-01-01

    Eating disorders affect all ethnic and socioeconomic groups. However, evidence based treatments for eating disorders have been developed and tested exclusively on Caucasian populations. With the purpose to develop a culturally sensitive framework for the eating disorders treatment in Latinos/as, the objectives of this work were: 1) identify and describe some of the relevant cultural elements for eating disorders in the Latino population and, 2) to draft a culturally sensitive intervention model for eating disorders in Latino population in the United States. Providing culturally sensitive treatments for Latinos with psychiatric disorders is essential to reverse public health disparities. PMID:22003472

  20. ROLE OF PARENTERAL NUTRITION IN ONCOLOGIC PATIENTS WITH INTESTINAL OCCLUSION AND PERITONEAL CARCINOMATOSIS.

    PubMed

    Aría Guerra, Eva; Cortés-Salgado, Alfonso; Mateo-Lobo, Raquel; Nattero, Lía; Riveiro, Javier; Vega-Piñero, Belén; Valbuena, Beatriz; Carabaña, Fátima; Carrero, Carmen; Grande, Enrique; Carrato, Alfredo; Botella-Carretero, José Ignacio

    2015-09-01

    Introducción y objetivos: el papel preciso de la nutrición parenteral en el manejo de los pacientes oncológicos con obstrucción intestinal no está bien definido todavía. El objetivo del presente trabajo es evaluar los efectos de la nutrición parenteral en este tipo de pacientes en cuanto al pronóstico. Material y métodos: fueron incluidos 55 pacientes con obstrucción intestinal y carcinomatosis peritoneal. La nutrición parenteral proporcionó 20-35 kcal/Kg/día y 1.0 g/kg/día de aminoácidos. El peso, el IMC, el tipo de tumor, el tipo de quimioterapia recibida y el ECOG, entre otras variables, fueron recogidas y analizadas. Resultados: un 69,1% de los pacientes presentaban tumors gastrointestinales, un 18,2% ginecológicos y otros tumores el 12,7% restante. La edad media fue de 60 ± 13 años, con un ECOG basal de 1,5 ± 0,5 y un IMC de 21,6 ± 4,3. La presencia de malnutrición fue de un 85%. La supervivencia desde el inicio de la nutrición parenteral no fue significativamente distinta entre los pacientes al considerar su ECOG basal (log rank = 0,593, p = 0,743), las líneas previas de quimioterapia recibida (log rank = 2,117, p = 0,548), el IMC basal (log rank = 2,686, p = 0,261), o el tipo de tumor (log rank = 2,066, p = 0,356). La supervivencia en los pacientes en que fue posible el alta hospitalaria con nutrición parenteral fue superior (log rank = 7,090, p = 0,008). La supervivencia en los pacientes en que se inició la quimioterapia durante o tras iniciar la nutrición parenteral fue también superior (log rank = 17,316, p < 0,001). Un total de 3,6% de los pacientes presentaron infección relacionada con el catéter sin afectar la supervivencia (log rank = 0,061, p = 0,804). Conclusión: la nutrición parenteral en los pacientes oncológicos con obstrucción intestinal y carcinomatosis peritoneal es segura y, en aquellos que responden a qui mioterapia, el uso de la nutrición parenteral domiciliaria, junto con en tratamiento antitumoral activo

  1. Nuevas oportunidades de inmunoterapia dirigida

    Cancer.gov

    Un equipo de investigadores del NCI ha informado que varios tipos de cánceres gastrointestinales tienen mutaciones específicas al tumor que pueden ser reconocidas por el sistema inmunitario, lo que ofrece una posible oportunidad terapéutica para pacientes

  2. Irinotecan, Fluorouracil, and Leucovorin in Treating Patients With Advanced Gastrointestinal Cancer

    ClinicalTrials.gov

    2016-04-19

    Anal Cancer; Carcinoma of the Appendix; Colorectal Cancer; Esophageal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Gastrointestinal Carcinoid Tumor; Gastrointestinal Stromal Tumor; Liver Cancer; Pancreatic Cancer; Small Intestine Cancer

  3. Indium In 111 Pentetreotide in Treating Patients With Refractory Cancer

    ClinicalTrials.gov

    2014-07-01

    Brain and Central Nervous System Tumors; Childhood Langerhans Cell Histiocytosis; Gastrointestinal Carcinoid Tumor; Head and Neck Cancer; Intraocular Melanoma; Islet Cell Tumor; Kidney Cancer; Lung Cancer; Melanoma (Skin); Neoplastic Syndrome; Neuroendocrine Carcinoma of the Skin; Pheochromocytoma

  4. Gastroscopic follow up of pernicious anaemia patients.

    PubMed Central

    Sjöblom, S M; Sipponen, P; Järvinen, H

    1993-01-01

    To assess the value of gastroscopic cancer surveillance of patients with pernicious anaemia, 56 patients were re-endoscoped and biopsied after three years. In addition, changes in the density of fundic mucosal endocrine cells were evaluated morphometrically. Two cases (3.6%) of early gastric cancer and two cases of small gastric carcinoid tumours (3.6%) were detected in addition to the five carcinoids that had been found at the initial endoscopic screening. Nodular argyrophil cell hyperplasia and morphometric density of argyrophil cells were not stable phenomena: nodular hyperplasias regressed in five patients, remained similar in six, and progressed to a small carcinoid tumour in one. Serum gastrin concentrations did not correlate well with changes in the endocrine cell density. Regular endoscopic surveillance for gastric cancer may be beneficial and realistic in young patients with pernicious anaemia while the importance of fundic endocrine cell hyperplasia and that of small gastric carcinoids need further study. PMID:8432447

  5. Palonosetron Hydrochloride in Preventing Nausea and Vomiting Caused by Radiation Therapy in Patients With Primary Abdominal Cancer

    ClinicalTrials.gov

    2016-08-11

    Anal Cancer; Carcinoma of the Appendix; Colorectal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Gastrointestinal Carcinoid Tumor; Liver Cancer; Nausea and Vomiting; Pancreatic Cancer; Primary Peritoneal Cavity Cancer; Small Intestine Cancer

  6. Everolimus and Vatalanib in Treating Patients With Advanced Solid Tumors

    ClinicalTrials.gov

    2016-04-18

    Gastrinoma; Glucagonoma; Insulinoma; Metastatic Gastrointestinal Carcinoid Tumor; Metastatic Pheochromocytoma; Pancreatic Polypeptide Tumor; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Recurrent Melanoma; Recurrent Neuroendocrine Carcinoma of the Skin; Recurrent Non-small Cell Lung Cancer; Recurrent Pheochromocytoma; Recurrent Renal Cell Cancer; Somatostatinoma; Stage III Neuroendocrine Carcinoma of the Skin; Stage IV Melanoma; Stage IV Non-small Cell Lung Cancer; Stage IV Renal Cell Cancer; Thyroid Gland Medullary Carcinoma; Unspecified Adult Solid Tumor, Protocol Specific

  7. Los pronombres de cortesia: su tratamiento en espanol y en otros idiomas, El adverbio (Pronouns of Courtesy: Their Treatment in Spanish and Other Languages, the Adverbs)

    ERIC Educational Resources Information Center

    Criado de Val, Manuel

    1973-01-01

    Compares use of pronouns and adverbs in Spanish, French, Italian, Portuguese, English, German, Rumanian, and Slavic languages. Excerpted from the book Fisonomia del y de las lenguas modernas'' ( Features of Modern Languages''). (DS)

  8. Testing road surface treatments to reduce erosion in forest roads in Honduras [Tratamientos de la superficie de rodadura para reducir la erosion en caminos forestales en Honduras

    USGS Publications Warehouse

    Rivera, Samuel; Kershner, Jeffrey L.; Keller, Gordon R.

    2009-01-01

    Testing road surface treatments to reduce erosion in forest roads in Honduras. Cien. Inv. Agr. 36(3):425-432. Using forest roads produces more erosion and sedimentation than any other forest or agricultural activity. This study evaluated soil losses from a forest road in central Honduras over two consecutive years. We divided a 400-m segment of road into 8 experimental units, each 50 m in length. Four units were treated with Best Management Practices (BMPs) and four were left untreated. The BMP treatments included reshaping the road prism, installing culverts and reshaping of road ditches, compacting 20-cm layers of the road tread, crowning the road surface (3% slope, double drainage), longitudinal sloping (less than 12%), and adding a 10-cm layer of gravel (crush size = 0.63 cm). Soil movement was measured daily during the rainy seasons. The highest soil loss occurred in the control road, around 500 m3 km-1 per year, while the road treated with BMP lost approximately 225 m3km-1 per year. These results show that road surface erosion can be reduced up to 50% with the implementation of surface treatments.

  9. [Neuroendocrine neoplasms of the mediastinum].

    PubMed

    Brcic, L; Heidinger, M; Popper, H

    2016-09-01

    Primary neuroendocrine tumors (NET) in the mediastinum are very rare and among them thymic NETs are the most common. They represent 5 % of all thymic and mediastinal tumors. The WHO classification from 2015 subdivides thymic NETs into three groups; low grade (typical carcinoid), intermediate grade (atypical carcinoid) and high grade (large cell neuroendocrine carcinoma and small cell carcinoma). Through this change of mediastinal/thymic NET classification into three groups of malignancy, the nomenclature was adapted to that of the lungs, while the histological criteria for each entity remained the same. Thymic NETs typically occur in middle-aged adults and predominantly in males. Approximately 30 % are asymptomatic and the rest present with symptoms caused by local tumor growth, distant metastases and/or endocrine manifestations. Carcinoids can also occur as a part of multiple endocrine neoplasia type 1 (MEN1) and at the time of diagnosis commonly present with regional lymph node or distant metastases, which most often affect the lungs and bones. For the correct diagnosis tumor cell morphology, mitotic count and/or necrosis are crucial. Patients with typical carcinoids have the best prognosis, whereas the prognosis is slightly worse for atypical carcinoids but very poor for large cell neuroendocrine carcinomas. Small cell carcinomas have the worst prognosis and the shortest median survival time of approximately 14 months.

  10. Human biodistribution of [111In]diethylenetriaminepentaacetic acid-(DTPA)-D-[Phe1]-octreotide and peroperative detection of endocrine tumors.

    PubMed

    Ohrvall, U; Westlin, J E; Nilsson, S; Wilander, E; Juhlin, C; Rastad, J; Akerström, G

    1995-12-01

    Requisites for preoperative and intraoperative tumor localization with [111In]diethylenetriaminepentaacetic acid-D-[Phe1]-octreotide scanning were explored in 23 patients with endocrine tumors (15 carcinoids, 4 insulinomas, and single cases of gastrinoma, medullary thyroid carcinoma, aldosteronoma, and paraganglioma). The patients were subjected to Octreoscan single photon emission computed tomographic examination prior to surgery and well counter investigation of nuclide uptake in tumors and normal tissues sampled at surgery. Somatostatin receptor-positive tumors demonstrated efficient nuclide accumulation with mean tumor:blood radioactivity ratios of 180-370 (for carcinoids and insulinoma), compared with tissue:blood ratios of 302 for spleen, 42 for liver, and < 10-15 in other normal tissues (pancreas, small intestine, and mesenteric fat). Inefficient preoperative visualization of lesions was related to inconspicuous size, as for primary intestinal carcinoids, tiny liver metastases, and a single small insulinoma. High background activity, pronounced tumor fibrosis, and meager accumulation of tracer also interfered with visualization. Tumor deposits in organs with low background activity (such as carcinoid mesenteric metastases and endocrine pancreatic tumors) were generally most readily detected. Intraoperative investigations with hand-held gamma detector probes were disturbed by obvious high background activity. These investigations revealed two preoperatively unrecognized primary intestinal carcinoids, which, however, were both palpable during surgery. These studies, therefore, had little impact on the surgical strategy. PMID:7493348

  11. [Neuroendocrine neoplasms of the mediastinum].

    PubMed

    Brcic, L; Heidinger, M; Popper, H

    2016-09-01

    Primary neuroendocrine tumors (NET) in the mediastinum are very rare and among them thymic NETs are the most common. They represent 5 % of all thymic and mediastinal tumors. The WHO classification from 2015 subdivides thymic NETs into three groups; low grade (typical carcinoid), intermediate grade (atypical carcinoid) and high grade (large cell neuroendocrine carcinoma and small cell carcinoma). Through this change of mediastinal/thymic NET classification into three groups of malignancy, the nomenclature was adapted to that of the lungs, while the histological criteria for each entity remained the same. Thymic NETs typically occur in middle-aged adults and predominantly in males. Approximately 30 % are asymptomatic and the rest present with symptoms caused by local tumor growth, distant metastases and/or endocrine manifestations. Carcinoids can also occur as a part of multiple endocrine neoplasia type 1 (MEN1) and at the time of diagnosis commonly present with regional lymph node or distant metastases, which most often affect the lungs and bones. For the correct diagnosis tumor cell morphology, mitotic count and/or necrosis are crucial. Patients with typical carcinoids have the best prognosis, whereas the prognosis is slightly worse for atypical carcinoids but very poor for large cell neuroendocrine carcinomas. Small cell carcinomas have the worst prognosis and the shortest median survival time of approximately 14 months. PMID:27507161

  12. Microsatellite alteration at chromosome 3p loci in neuroendocrine and non-neuroendocrine lung tumors. Histogenetic and clinical relevance.

    PubMed Central

    Hurr, K.; Kemp, B.; Silver, S. A.; el-Naggar, A. K.

    1996-01-01

    Although chromosome 3p regions are the most frequent site for genetic alterations in small-cell lung carcinoma (SCLC) and non-small-cell lung carcinoma (NSCLC), the extent of such abnormality in carcinoid tumors remained to be investigated. Moreover, the histogenetic and biological implications of these findings in non-carcinoid lung tumors remain unclear. We studied eight microsatellite loci on chromosome 3p regions by multiplex polymerase chain reaction in paired normal and tumor DNA from 17 carcinoid tumors, 5 SCLCs, and 38 NSCLCs to determine the histogenetic and the clinical significance of their alterations in these neoplasms. Our results revealed a lack of microsatellite abnormalities at all loci tested in both typical and atypical carcinoid tumors. SCLCs and NSCLCs showed loss of heterozygosity in 100% (5/5) and 58.0% (22/38), respectively. Loss of heterozygosity at more than two loci correlated significantly with poor histological differentiation and were preponderantly found in high proliferative index and DNA aneuploid NSCLCs. Microsatellite instability was noted in only one (1.7%) of the lesions. Our study suggests that 1) the difference in chromosome 3p alterations between carcinoid tumors and SCLCs favors a stochastic rather than linear evolution of these tumors, 2) 3p alterations may constitute an initial event in the development of small cell carcinomas, and 3) loss of heterozygosity at 3p loci is associated with aggressive tumor characteristics in non-small-cell carcinomas. Images Figure 2 PMID:8701999

  13. The dynamic histopathologic spectrum of lung cancer.

    PubMed

    Yesner, R

    1981-01-01

    The APUD concept has postulated that pulmonary carcinoids and small cell carcinomas arise from the neural crest. In development from hypothesis to tautology is traced, and evidence is presented that all pulmonary epithelial tumors arise from the primitive endoderm. Morphologic studies show that a dynamic spectrum exists. Not only do various cell types appear within a single section, but cell types may change from biopsy to autopsy with or without chemotherapy. The spectrum is sustained at the ultramicroscopic level in regard to organelles such as desmosomes, tonofibrils, and dense core granules. Secretory products such as ACTH and L-dopa decarboxylase also show that all lung cancers are related. Epidemiologic evidence indicates that small cell carcinomas in uranium miners occur after prolonged squamous cell dysplasia, and that carcinoids occur independently of external carcinogens, but show transitions to other tumors. Finally, experimental evidence indicates that the K cells, to which carcinoids are most closely related, are of local origin.

  14. Primary bronchial tumors in childhood. A clinicopathologic study of six cases.

    PubMed

    Lack, E E; Harris, G B; Eraklis, A J; Vawter, G F

    1983-02-01

    A primary bronchial tumor was diagnosed in six children younger than age 12 years. These cases include four bronchial carcinoids, a low-grade mucoepidermoid carcinoma, and a granular cell tumor ("myoblastoma"). Lobar or segmental resection was performed in each case and remains the treatment of choice. The most common bronchial tumors in childhood are carcinoids with 17 other evaluable cases in the English Literature. This series includes the youngest child to be reported with bilateral choroidal metastases leading to blindness; in addition, there were clinical manifestations of gigantism and acromegaly possibly related to ectopic hormone production. Low-grade mucoepidermoid carcinomas rank second in frequency to carcinoids and have an excellent prognosis. Judging from the childhood bronchial tumors reported to date, proved examples of bronchogenic carcinoma are vanishingly rare. PMID:6295603

  15. Immunotherapy for gastric premalignant lesions and cancer.

    PubMed

    Zorzetto, Valerio; Maddalo, Gemma; Basso, Daniela; Farinati, Fabio

    2012-06-01

    Chronic atrophic gastritis, a precancerous change for gastric cancer, shows a loss of appropriate glands, Helicobacter pylori infection and autoimmune gastritis being the two main etiologic factors. While H. pylori eradication is the mandatory treatment for the former, no etiologic treatment is available for the latter, in which a Th1-type response, modulated by Tregs and Th17 cells, is involved. H. pylori-related atrophic gastritis is a risk factor for gastric adenocarcinoma, while autoimmune atrophic gastritis is also linked to a substantial risk of gastric type I carcinoid, related to the chronic stimulus exerted by hypergastrinemia on enterochromaffin-like cells. Several studies have been published on gastric cancer treatment through an active specific immunotherapy, aimed at improving the immunoregulatory response and increasing the circulating tumor-specific T cells. No study on immunotherapy of carcinoids is available but, in our experience, the administration of an antigastrin 17 vaccine induced carcinoid regression in two out of three patients treated.

  16. Pancreatic endocrine tumors: recent advances.

    PubMed

    Jensen, R T

    1999-01-01

    Pancreatic endocrine tumors (PET's) can be divided on a clinical and pathologic basis into ten classes [insulinomas, gastrinomas (Zollinger-Ellison syndrome), VIPomas (Verner-Morrison syndrome, WDHA, pancreatic cholera), glucagonomas, somatostatinomas, ACTH-releasing tumors (ACTHomas), growth hormone-releasing factor secreting tumors (GRFomas), nonfunctioning or pancreatic polypeptide secreting tumors (non-functioning PET), PET's causing carcinoid syndrome and PET's causing hypercalcemia)]. Recent reports suggest calcitonin-secreting PET's also rarely occur but whether they cause a distinct clinical syndrome is unclear. PET's resemble carcinoid tumors histologically; in their ability to synthesize and frequently secrete multiple peptides such as neuroendocrine cell markers (chromogranins); their biologic behavior and their tumor growth patterns. Both groups of tumors are highly vascular, have high densities of somatostatin receptors and similar tumor localization studies including somatostatin receptor scintigraphy are used for both. PET's, similar to carcinoids causing the carcinoid syndrome, require two separate treatment options be considered: treatment directed against the hormone-excess state and treatment directed against the tumor per se because of their malignant nature. In the last few years there have been advances in tumor diagnosis, localization methods, treatment approaches particularly related to the use of synthetic somatostatin analogues, and the definition of the role of surgical procedures in these diseases. Important other advances include insights into the long-term natural history of PET's particularly from studies of gastrinomas, which allow prognostic factors to be identified and the timing of treatment options to better planned, as well as insights into the molecular basis of these disorders. The latter includes both a description of the molecular basis of the genetic inherited syndromes associated with PET's or carcinoid tumors, as well as

  17. The pituitary V3 vasopressin receptor and the corticotroph phenotype in ectopic ACTH syndrome.

    PubMed

    de Keyzer, Y; Lenne, F; Auzan, C; Jégou, S; René, P; Vaudry, H; Kuhn, J M; Luton, J P; Clauser, E; Bertagna, X

    1996-03-01

    Ectopic ACTH secretion occurs in highly differentiated and rather indolent tumors like bronchial carcinoids or, in contrast, in various types of aggressive and poorly differentiated neuroendocrine tumors. We explored this phenomenon using the recently cloned human pituitary V3 vasopressin receptor as an alternate molecular marker of the corticotroph phenotype. Expression of V3 receptor, corticotrophin releasing hormone (CRH) receptor, and proopiomelanocortin (POMC) genes was examined in tumors of pituitary and nonpituitary origin. A comparative RT-PCR approach revealed signals for both V3 receptor and CHR receptor mRNAs in 17 of 18 ACTH-secreting pituitary adenomas, and 6 of 6 normal pituitaries; in six growth hormone- or prolactin-secreting adenomas, a very faint V3 receptor signal was observed in three cases, and CRH receptor signal was undetected in all. Six of eight bronchial carcinoids responsible for the ectopic ACTH syndrome had both POMC and V3 receptor signals as high as those in ACTH-secreting pituitary adenomas; in contrast, no POMC signal and only a very faint V3 receptor signal were detected in six of eight nonsecreting bronchial carcinoids. Northern blot analysis showed V3 receptor mRNA of identical size in ACTH-secreting bronchial carcinoids and pituitary tumors. Other types of nonpituitary tumors responsible for ectopic ACTH syndrome presented much lower levels of both POMC and V3 receptor gene expression than those found in ACTH-secreting bronchial carcinoids. In contrast with the V3 receptor, CRH receptor mRNA was detected in the majority of neuroendocrine tumors irrespective of their POMC status. These results show that expression of the V3 receptor gene participates in the corticotroph phenotype. Its striking association with ACTH-secreting bronchial carcinoids defines a subset of nonpituitary tumors in which ectopic POMC gene expression is but one aspect of a wider process of corticotroph cell differentiation, and opens new possibilities of

  18. Classification and Pathology of Lung Cancer.

    PubMed

    Zheng, Min

    2016-07-01

    Advancement in the understanding of lung tumor biology enables continued refinement of lung cancer classification, reflected in the recently introduced 2015 World Health Organization classification of lung cancer. In small biopsy or cytology specimens, special emphasis is placed on separating adenocarcinomas from the other lung cancers to effectively select tumors for targeted molecular testing. In resection specimens, adenocarcinomas are further classified based on architectural pattern to delineate tissue types of prognostic significance. Neuroendocrine tumors are divided into typical carcinoid, atypical carcinoid, small cell carcinoma, and large cell neuroendocrine carcinoma based on a combination of features, especially tumor cell proliferation rate. PMID:27261908

  19. [Anorectal neuroendocrine carcinoma: observations on a case and review of the literature].

    PubMed

    Messinetti, S; Giacomelli, L; Drudi, F M; Innocenzi, D; Porcelli, C; Fabrizio, G; Finizio, R; Manno, A; Granai, A V

    1994-01-01

    Carcinoid tumours of the anorectum are rare (0.7% of malignant rectal tumours). Because of this rarity several aspects of the management of these tumours remain controversial. Diagnosis may be delayed because of failure to recognize their morphological characteristics and histological appearance may not reflect their biological behaviour. Immunocytochemistry for neuroendocrine-cells are essential to identify different types of carcinoid tumours and to do differential diagnosis from other malignant tumours. All that allow an exact therapeutic approach to these tumours. The tumours less than cm 1 in diameter can be safely treated by local excision; the tumours more than cm 1 in diameter are treated by radical surgery (AAP).

  20. Surgical management of the ectopic ACTH syndrome.

    PubMed Central

    Davies, C J; Joplin, G F; Welbourn, R B

    1982-01-01

    Most patients with extra-pituitary ACTH-secreting tumors die from carcinoma, but a few can benefit from operation. Of 96 patients with Cushing's syndrome, 11 probably had such tumors. There were three modes of presentation: (1) three had malignant tumors with visceral metastases initially. One (bronchial carcinoid) died without operation. Two with carcinoma (thyroid medullary and islet-cell) underwent adrenalectomy with remission, but died soon. (2) three had apparently benign tumors initially. One (appendicular carcinoid) underwent appendectomy and one (bronchial carcinoid with hilar node metastases) underwent lobectomy. Both had rapid remissions. The third (pheochromocytoma) died after resection of the tumor. (3) five patients had no obvious tumors and underwent adrenalectomy with remission. In one a benign bronchial carcinoid was removed later. Four others remain well, but without localizing signs of tumor. The main biochemical features in all were hypokalemic alkalosis and very high urinary excretion of free cortisol. Seven of the eight patients without visceral metastases are in remission from one to 15 years after operation. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:6287949

  1. Identification of deregulation of apoptosis and cell cycle in neuroendocrine tumors of the lung via NanoString nCounter expression analysis

    PubMed Central

    Walter, Robert Fred Henry; Werner, Robert; Ting, Saskia; Vollbrecht, Claudia; Theegarten, Dirk; Christoph, Daniel Christian; Schmid, Kurt Werner; Wohlschlaeger, Jeremias; Mairinger, Fabian Dominik

    2015-01-01

    Background Neuroendocrine tumors of the lung comprise typical (TC) and atypical carcinoids (AC), large-cell neuroendocrine cancer (LCNEC) and small-cell lung cancer (SCLC). Cell cycle and apoptosis are key pathways of multicellular homeostasis and deregulation of these pathways is associated with cancerogenesis. Materials and Methods Sixty representative FFPE-specimens (16 TC, 13 AC, 16 LCNEC and 15 SCLC) were used for mRNA expression analysis using the NanoString technique. Eight genes related to apoptosis and ten genes regulating key points of cell cycle were investigated. Results ASCL1, BCL2, CASP8, CCNE1, CDK1, CDK2, CDKN1A and CDKN2A showed lower expression in carcinoids compared to carcinomas. In contrast, CCNE1 and CDK6 showed elevated expression in carcinoids compared to carcinomas. The calculated BCL2/BAX ratio showed increasing values from TC to SCLC. Between SCLC and LCNEC CDK2, CDKN1B, CDKN2A and PNN expression was significantly different with higher expression in SCLC. Conclusion Carcinoids have increased CDK4/6 and CCND1 expression controlling RB1 phosphorylation via this signaling cascade. CDK2 and CCNE1 were increased in carcinomas showing that these use the opposite way to control RB1. BAX and BCL2 are antagonists in regulating apoptosis. BCL2 expression increased over BAX expression with increasing malignancy of the tumor from TC to SCLC. PMID:26008974

  2. Corticotropin-releasing hormone, proopiomelanocortin, and glucocorticoid receptor gene expression in adrenocorticotropin-producing tumors in vitro.

    PubMed Central

    Suda, T; Tozawa, F; Dobashi, I; Horiba, N; Ohmori, N; Yamakado, M; Yamada, M; Demura, H

    1993-01-01

    To differentiate between ectopic ACTH syndrome and Cushing's disease, gene expression of corticotropin-releasing hormone (CRH), proopiomelanocortin (POMC), and glucocorticoid receptor was examined in 10 pituitary adenomas (Cushing's disease) and in 10 ectopic ACTH-producing tumors. CRH increased plasma ACTH levels in all patients with Cushing's disease and in five patients with ectopic ACTH syndrome whose tumors contained CRH and CRH mRNA. In five CRH nonresponders, CRH was not detected in tumors that contained no CRH mRNA or that contained only long-size CRH mRNA. Dexamethasone (Dex) decreased plasma ACTH levels in all patients with Cushing's disease and in three patients with ectopic ACTH-producing bronchial carcinoid. These tumors contained glucocorticoid receptor mRNA. CRH increased and Dex decreased ACTH release and POMC mRNA levels in pituitary adenoma and bronchial carcinoid cells. PMA increased POMC mRNA levels only in carcinoid cells. These results reveal characteristics of ectopic ACTH-producing tumors: long-size CRH mRNA and PMA-induced POMC gene expression. In addition, there are two ectopic ACTH syndrome subtypes: tumors containing ACTH with CRH (CRH responder) and tumors without CRH. Dex decreases ACTH release and POMC mRNA levels in some bronchial carcinoids. Therefore, CRH and Dex tests have limited usefulness in differentiating between Cushing's disease and ectopic ACTH syndrome. Images PMID:8254033

  3. Pazopanib Hydrochloride in Treating Patients With Advanced Neuroendocrine Cancer

    ClinicalTrials.gov

    2015-10-15

    Gastrin-Producing Neuroendocrine Tumor; Lung Carcinoid Tumor; Metastatic Digestive System Neuroendocrine Tumor G1; Multiple Endocrine Neoplasia Type 1; Pancreatic Glucagonoma; Pancreatic Insulinoma; Pancreatic Polypeptide Tumor; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Pancreatic Neuroendocrine Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Somatostatin-Producing Neuroendocrine Tumor

  4. Trebananib And Temsirolimus in Treating Patients With Solid Tumors That Are Metastatic or Cannot Be Removed by Surgery

    ClinicalTrials.gov

    2015-10-05

    Adult Solid Neoplasm; Lung Carcinoid Tumor; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Renal Cell Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage III Renal Cell Cancer; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IV Renal Cell Cancer; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma

  5. Cixutumumab, Everolimus, and Octreotide Acetate in Treating Patients With Advanced Low to Intermediate Grade Neuroendocrine Carcinoma

    ClinicalTrials.gov

    2016-07-14

    Gastrin-Producing Neuroendocrine Tumor; Lung Carcinoid Tumor; Metastatic Digestive System Neuroendocrine Tumor G1; Pancreatic Glucagonoma; Pancreatic Insulinoma; Pancreatic Polypeptide Tumor; Paraganglioma; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Merkel Cell Carcinoma; Recurrent Pancreatic Neuroendocrine Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Somatostatin-Producing Neuroendocrine Tumor; Stage III Merkel Cell Carcinoma; Stage IV Merkel Cell Carcinoma; Thyroid Gland Medullary Carcinoma

  6. [Treatment of type 2 diabetes mellitus in patients with chronic kidney disease. Grupo de Trabajo para el Documento de Consenso sobre el tratamiento de la diabetes tipo 2 en el paciente con enfermedad renal crónica].

    PubMed

    Gómez-Huelgas, Ricardo; Martínez-Castelao, Alberto; Artola, Sara; Górriz, José Luis; Menéndez, Edelmiro

    2014-01-21

    Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are highly prevalent chronic diseases, which represent an important public health problem and require a multidisciplinary management. T2DM is the main cause of CKD and it also causes a significant comorbidity with regard to non-diabetic nephropathy. Patients with diabetes and kidney disease represent a special risk group as they have higher morbi-mortality as well as higher risk of hypoglycemia than diabetic individuals with a normal kidney function. Treatment of T2DM in patients with CKD is controversial because of the scarcity of available evidence. The current consensus report aims to ease the appropriate selection and dosage of antidiabetic treatments as well as the establishment of safety objectives of glycemic control in patients with CKD. PMID:24268912

  7. Primary angioplasty vs. fibrinolysis in very old patients with acute myocardial infarction: TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) randomized trial and pooled analysis with previous studies

    PubMed Central

    Bueno, Héctor; Betriu, Amadeo; Heras, Magda; Alonso, Joaquín J.; Cequier, Angel; García, Eulogio J.; López-Sendón, José L.; Macaya, Carlos; Hernández-Antolín, Rosana; Bueno, Héctor; Hernández-Antolín, Rosana; Alonso, Joaquín J.; Betriu, Amadeo; Cequier, Angel; García, Eulogio J.; Heras, Magda; López-Sendón, José L.; Macaya, Carlos; Azpitarte, José; Sanz, Ginés; Chamorro, Angel; López-Palop, Ramón; Sionis, Alex; Arós, Fernando; García-Fernández, Eulogio; Rubio, Rafael; Hernández, Felipe; Tascón, Juan Carlos; Moreu, José; Betriu, Amadeu; Heras, Magda; Hernández-Antolín, Rosana; Fernández-Ortiz, Antonio; Morís, César; de Posada, Ignacio Sánchez; Cequier, Ángel; Esplugas, Enrique; Melgares, Rafael; Bosa, Francisco; García-González, Martín Jesús; Lezáun, Román; Carmona, José Ramón; Vázquez, José Manuel; Castro-Beiras, Alfonso; Picart, Joan García; de Rozas, José Domínguez; Fernández, José Díaz; Vázquez, Felipe Fernández; Alonso, Norberto; Zueco, José Javier; San José, José María; San Román, Alberto; Hernández, Carolina; García, José María Hernández; Alcántara, Ángel García; Bethencourt, Armando; Fiol, Miquel; Mancisidor, Xabier; Mancisidor, Xabier; Ruiz, Rafael; Hidalgo, Rafael; Sobrino, Nicolás; Maqueda, Isidoro González; Torres, Alfonso; Arós, Fernando; Amaro, Antonio; Jaquet, Michel

    2011-01-01

    Aims To compare primary percutaneous coronary intervention (pPCI) and fibrinolysis in very old patients with ST-segment elevation myocardial infarction (STEMI), in whom head-to-head comparisons between both strategies are scarce. Methods and results Patients ≥75 years old with STEMI <6 h were randomized to pPCI or fibrinolysis. The primary endpoint was a composite of all-cause mortality, re-infarction, or disabling stroke at 30 days. The trial was prematurely stopped due to slow recruitment after enroling 266 patients (134 allocated to pPCI and 132 to fibrinolysis). Both groups were well balanced in baseline characteristics. Mean age was 81 years. The primary endpoint was reached in 25 patients in the pPCI group (18.9%) and 34 (25.4%) in the fibrinolysis arm [odds ratio (OR), 0.69; 95% confidence interval (CI) 0.38–1.23; P = 0.21]. Similarly, non-significant reductions were found in death (13.6 vs. 17.2%, P = 0.43), re-infarction (5.3 vs. 8.2%, P = 0.35), or disabling stroke (0.8 vs. 3.0%, P = 0.18). Recurrent ischaemia was less common in pPCI-treated patients (0.8 vs. 9.7%, P< 0.001). No differences were found in major bleeds. A pooled analysis with the two previous reperfusion trials performed in older patients showed an advantage of pPCI over fibrinolysis in reducing death, re-infarction, or stroke at 30 days (OR, 0.64; 95% CI 0.45–0.91). Conclusion Primary PCI seems to be the best reperfusion therapy for STEMI even for the oldest patients. Early contemporary fibrinolytic therapy may be a safe alternative to pPCI in the elderly when this is not available. Clinicaltrials.gov # NCT00257309. PMID:20971744

  8. [Treatment of type 2 diabetes mellitus in patients with chronic kidney disease. Grupo de Trabajo para el Documento de Consenso sobre el tratamiento de la diabetes tipo 2 en el paciente con enfermedad renal crónica].

    PubMed

    Gómez-Huelgas, Ricardo; Martínez-Castelao, Alberto; Artola, Sara; Górriz, José Luis; Menéndez, Edelmiro

    2014-01-21

    Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are highly prevalent chronic diseases, which represent an important public health problem and require a multidisciplinary management. T2DM is the main cause of CKD and it also causes a significant comorbidity with regard to non-diabetic nephropathy. Patients with diabetes and kidney disease represent a special risk group as they have higher morbi-mortality as well as higher risk of hypoglycemia than diabetic individuals with a normal kidney function. Treatment of T2DM in patients with CKD is controversial because of the scarcity of available evidence. The current consensus report aims to ease the appropriate selection and dosage of antidiabetic treatments as well as the establishment of safety objectives of glycemic control in patients with CKD.

  9. [Guía latinoamericana para el diagnóstico y tratamiento de alergia a las proteínas de la leche de vaca (GL-APLV)].

    PubMed

    Montijo-Barrios, Ericka; López-Ugalde, Martha Verónica; Ramírez-Mayans, Jaime; Anaya-Flórez, María Salomé; Arredondo-García, José Luis; Azevedo-Tenorio, Isaac; Bacarreza-Nogales, Dante; Bautista-Silva, Miriam G; Cáceres-Cano, Pablo Andrés; Cáceres-Mendoza, César Augusto; Cadena-León, José Francisco; Cadranel, Samy; Carbajal-Rodríguez, Luis; Castillo-de-León, Yolanda A; Cázares-Méndez, Josefina Monserrat; Cervantes-Bustamante, Roberto; Colindres-C, Ediltrudys; Cossío-Ochoa, Enna Alicia; Chanis-Águila, Ricardo; Chávez-Barrera, José Antonio; Escobar-Castro, Héctor; Fernández-Aragón, Marlon; Fernández-Carrocera, Luis Alberto; Flores, Alejandro; Flores-Calderón, Judith; Galaz-Pantoja, Manuel Enrique; García-Dávila, Marycruz; Heller-Rouassant, Solange; Hernández-Bautista, Víctor Manuel; Higuera-Benítez, Jorge; Huerta-Hernández, Rosa Elena; Huerta-López, José G; Jovel-Banegas, Luis Enrique; Larrosa-Haro, Alfredo; Leal-Quevedo, Francisco Javier; León-Ramírez, Carlos; Limón-Rojas, Ana Elena; Lozano-Sáenz, José Santos; Mariño-Forero, Álvaro Eduardo; Márquez-Aguirre, Martha Patricia; Maruy-Saito, Aldo; Méndez-Nieto, Carlos Mario; Menéndez-Sandoval, José Fernando; Merlos-Fernández, Ivonne Guadalupe; Michel-Aceves, Reynaldo de Jesús; Michel-Penichet, Fernando; Munguía-Venegas, Pedro; Murillo-Márquez, Pedro; Navarro-A, Dianora C; Noronha-Spolidoro, José Vicente; Núñez-Barrera, Isela; Ordaz-Ortiz, Carlos Reyes; Ortega-Martell, José Antonio; Ortiz-López-de-Wyss, Ana Caroliona; Ovando-Fonseca, Jesús Elías; Oyervides-García, Carlos Iván; Palacios-Rosales, Jorge; Pinzón-Navarro, Adriana Beatriz; Quevedo-B, Rafael; Quito-Riera, Bolívar; Ramírez-Ortiz, Flor de María; Rivera-Medina, Juan; Romero-Trujillo, Jorge O; Sabra, Aderbal; Sáez-de-Ocariz-Gutiérrez, María Del Mar; Sánchez-Ortega, Analissa; Sánchez-Pérez, Maira Patricia; Sarmiento-Quintero, Fernando; Serrano-Sierra, Alejandro; Suárez-Cortina, Lucrecia; Tormo-Carnicé, Ramón; Toro-Monjaraz, Erick; Urquidi-Rivera, Martha Eugenia; Vásconez, Fabián; Vera, Fernando; Worona-Dibner, Liliana Beatriz; Zablah-Córdova, Roberto; Zamora-Dávila, Eduardo; Zárate-Mondragón, Flora

    2014-08-01

    Cow's milk allergy (CMA) is an immune-based disease that has become an increasing problem. The diagnosis and management of CMA varies from one clinical setting to another and represents a challenge in pediatric practice. In addition, because nonallergic food reactions can be confused with CMA symptoms, there is an overdiagnosis of the disease. In response to these situations, pediatric specialties from recognized institutions throughout Latin America decided to develop a clinical guideline for diagnosis and management of cow's milk allergy. These guidelines include definitions, epidemiology, pathophysiology overview, clinical and evidencebased recommendations for the diagnosis and treatment of CMA. They also include prevention and prognosis sections and identify gaps in the current knowledge to be addressed through future research.

  10. Tumeur stromale rectale: à propos d'une observation

    PubMed Central

    Rejab, Haitham; Kridis, Wala Ben; Ben Ameur, Hazem; Feki, Jihene; Frikha, Mounir; Beyrouti, Mohamed Issam

    2014-01-01

    Les tumeurs stromales gastro-intestinales sont des tumeurs mésenchymateuses peu fréquentes. Elles sont localisées préférentiellement eu niveau de l'estomac. La localisation rectale reste rare. A un nouveau cas de tumeur stromale du rectum ainsi qu'une bref revue de la littérature, on se propose d’étudier les particularités cliniques, radiologiques et thérapeutiques de cette entité rare. PMID:25120863

  11. Primary Malignancies of the Small Bowel: A Report of 96 Cases and Review of the Literature

    PubMed Central

    Wilson, James M.; Melvin, David B.; Gray, George F.; Thorbjarnarson, Bjorn

    1974-01-01

    The clinical records and histologic sections of 96 cases of primary small bowel malignancies (excluding lymphomas and periamullary lesions) were reviewed. The location, clinical presentation, pathologic findings, treatment and outcome are compared to the collected published experience, approximately 2400 cases. There were 48 adenocarcinomas, 37 carcinoids, and 11 leiomyosarcomas. Fifty-one men and 45 women ranged from 31 to 83 years old. Eighty-four caused symptoms leading to operative diagnosis; 12 carcinoids were incidental autopsy findings. The most common presentation was pain (33%) followed by weight loss (23%) obstruction (16%), hemorrhage (15%), jaundice (5%), intussusception (3%) and perforation (3%). Masses were felt in 30% of the cases, but were usually dilated bowel or intussusception rather than the tumor per se. Curative resection was attempted in 80 of 84 operatively diagnosed tumors. The 80% mortality among patients followed 5 years is attributed to the late appearance of symptoms and anatomic obstacles to a truly radical operation. PMID:4843046

  12. Veliparib, Capecitabine, and Temozolomide in Patients With Advanced, Metastatic, and Recurrent Neuroendocrine Tumor

    ClinicalTrials.gov

    2016-07-10

    Functional Pancreatic Neuroendocrine Tumor; Malignant Somatostatinoma; Merkel Cell Carcinoma; Metastatic Adrenal Gland Pheochromocytoma; Metastatic Carcinoid Tumor; Multiple Endocrine Neoplasia Type 1; Multiple Endocrine Neoplasia Type 2A; Multiple Endocrine Neoplasia Type 2B; Neuroendocrine Neoplasm; Non-Functional Pancreatic Neuroendocrine Tumor; Pancreatic Glucagonoma; Pancreatic Insulinoma; Recurrent Adrenal Cortex Carcinoma; Recurrent Adrenal Gland Pheochromocytoma; Recurrent Merkel Cell Carcinoma; Somatostatin-Producing Neuroendocrine Tumor; Stage III Adrenal Cortex Carcinoma; Stage III Thyroid Gland Medullary Carcinoma; Stage IIIA Merkel Cell Carcinoma; Stage IIIB Merkel Cell Carcinoma; Stage IV Adrenal Cortex Carcinoma; Stage IV Merkel Cell Carcinoma; Stage IVA Thyroid Gland Medullary Carcinoma; Stage IVB Thyroid Gland Medullary Carcinoma; Stage IVC Thyroid Gland Medullary Carcinoma; Thymic Carcinoid Tumor; VIP-Producing Neuroendocrine Tumor; Well Differentiated Adrenal Cortex Carcinoma; Zollinger Ellison Syndrome

  13. Growth-hormone-releasing factor immunoreactivity in human endocrine tumors.

    PubMed Central

    Bostwick, D. G.; Quan, R.; Hoffman, A. R.; Webber, R. J.; Chang, J. K.; Bensch, K. G.

    1984-01-01

    Seventy-three human tumors and adjacent nonneoplastic tissues were analyzed immunohistochemically for the presence of growth-hormone-releasing factor (GRF). Four of 9 pancreatic endocrine tumors, 2 of 3 appendiceal carcinoids, and 1 of 5 cecal carcinoids were immunoreactive for GRF. One of the GRF-containing pancreatic tumors was associated with acromegaly. Histologically, the growth patterns of these tumors were variable, and the distribution of immunoreactive cells was patchy and irregular. There were no normal cells that contained GRF. These results indicate that GRF production by human tumors is more common than previously thought, although clinical acromegaly may not be apparent in patients who harbor such neoplasms. Images Figure 1 PMID:6093542

  14. Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia of the Lung (DIPNECH): Current Best Evidence.

    PubMed

    Wirtschafter, Eric; Walts, Ann E; Liu, Sandy T; Marchevsky, Alberto M

    2015-10-01

    Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is recognized as a preneoplastic condition by the World Health Organization. We reviewed our experience with 30 patients and performed a systematic review of the English literature to collect best evidence on the clinical features and disease course in 169 additional patients. Some patients presented with one or more carcinoid tumors associated with multiple small pulmonary nodules on imaging studies and showed DIPNECH as a somewhat unexpected pathologic finding. Others presented with multiple small pulmonary nodules that raised suspicion of metastatic disease on imaging. A third subset was presented with previously unexplained respiratory symptoms. In most patients, DIPNECH was associated with a good prognosis, with chronological progression into a subsequent carcinoid tumor noted in only one patient and death attributed directly to DIPNECH in only two patients. There is no best evidence to support the use of octreotide, steroids, or bronchodilators in DIPNECH patients.

  15. Octreotide and Lanreotide in Gastroenteropancreatic Neuroendocrine Tumors.

    PubMed

    Pokuri, Venkata K; Fong, Mei Ka; Iyer, Renuka

    2016-01-01

    Neuroendocrine tumors are heterogeneous, rare malignancies that arise most commonly in the gastrointestinal tract and pancreas. They often secrete vasoactive substances resulting in carcinoid syndrome and the tumor cells exclusively express somatostatin receptors. Octreotide and lanreotide are the two synthetic somatostatin analogs used for the control of carcinoid symptoms and tumor progression in advanced inoperable disease. Recent pivotal trials (PROMID and CLARINET studies) established their antitumor activity. We discuss the available data to support their use as symptom controlling and antiproliferative agents. This article also reviews the guidelines (National Comprehensive Cancer Network and North American Neuro Endocrine Tumor Society), cost-analysis (suggesting the cost-effectiveness of lanreotide autogel compared to higher doses of octreotide long acting release formulation in refractory patients), and future directions of somatostatin analogs in the management of patients refractory to conventional doses of octreotide and lanreotide. PMID:26743514

  16. A functioning pleomorphic carcinoma of the thyroid.

    PubMed Central

    Karnauchow, P. N.

    1976-01-01

    A metastasizing functioning pleomorphic carcinoma of the thyroid displayed a morphologic piture ranging from follicular to sarcomatous and carcinoid-like patterns. Spindle-cell elements were believed to be the result of metaplasia of the follicular epithelium. Development of carcinoid-like lesions in the secondary deposits of tumour supported the contention that so-called parafollicular or c-cells may be a phenomenon of metaplasia and not a histologic entity. The tumour was associated with a chromophobe adenoma of the pituitary and a benign schwannoma of the stomach. Clinically the patient did not show any other endocrinologic abnormalities and lived for 4 years from the time of diagnosis of the thyroid tumour. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 PMID:1277059

  17. Pazopanib and depot octreotide in advanced, well-differentiated neuroendocrine tumours: a multicentre, single-group, phase 2 study

    PubMed Central

    Phan, Alexandria T; Halperin, Daniel M; Chan, Jennifer A; Fogelman, David R; Hess, Kenneth R; Malinowski, Paige; Regan, Eileen; Ng, Chaan S; Yao, James C; Kulke, Matthew H

    2015-01-01

    Summary Background Treatment options for advanced, well-differentiated neuroendocrine tumours (NETs) remain scarce. Pazopanib is an orally bioavailable, small molecule, multitargeted kinase inhibitor that inhibits VEGF receptors 1, 2, and 3. We did a study of the efficacy of pazopanib with depot octreotide in patients with advanced NETs. Methods We did a parallel cohort study of patients with metastatic or locally advanced grade 1–2 carcinoid tumours or pancreatic NETs, by use of a single-group, two-stage design. Patients received pazopanib 800 mg orally once per day and octreotide at their preprotocol dosage. The primary endpoint was the proportion of patients achieving an objective response, as assessed by investigators, by intention-to-treat analysis. This study is registered with ClinicalTrials.gov, identifier NCT00454363, and was completed in March, 2014. Findings Between April 12, 2007, and July 2, 2009, we enrolled 52 patients, including 32 individuals with pancreatic NETs and 20 individuals with carcinoid tumours. Seven (21.9%, 95% CI 11.0–38.8) of 32 patients with pancreatic NETs achieved an objective response. We detected no responses in the first stage of the cohort with carcinoid tumours, and we terminated accrual at 20 patients. Toxic effects included one patient with grade 4 hypertriglyceridaemia and one with grade 4 thrombosis, with the most common grade three events being aminotransferase increases and neutropenia, each of which happened in 3 patients. In all 52 patients, the most frequently observed toxic effects were fatigue (39 [75%]), nausea (33 [63%]), diarrhoea (33 [63%]), and hypertension (28 [54%]). Interpretation Treatment with pazopanib is associated with tumour response for patients with pancreatic NETs, but not for carcinoid tumours; a randomised controlled phase 3 study to assess pazopanib in advanced pancreatic NETs is warranted. Funding US National Cancer Institute of the National Institutes of Health. PMID:25956795

  18. Cardiac effects of noncardiac neoplasms

    SciTech Connect

    Schoen, F.J.; Berger, B.M.; Guerina, N.G.

    1984-11-01

    Clinically significant cardiovascular abnormalities may occur as secondary manifestations of noncardiac neoplasms. The principal cardiac effects of noncardiac tumors include the direct results of metastases to the heart or lungs, the indirect effects of circulating tumor products (causing nonbacterial thrombotic endocarditis, myeloma-associated amyloidosis, pheochromocytoma-associated cardiac hypertrophy and myofibrillar degeneration, and carcinoid heart disease), and the undesired cardiotoxicities of chemotherapy and radiotherapy. 89 references.

  19. Adenomatous tumors of the middle ear.

    PubMed

    Pelosi, Stanley; Koss, Shira

    2015-04-01

    Adenomatous tumors are an uncommon cause of a middle ear mass. Clinical findings may be nonspecific, leading to difficulties in differentiation from other middle ear tumors. Controversy also exists whether to classify middle ear adenoma and carcinoid as separate neoplasms, or alternatively within a spectrum of the same pathologic entity. Most adenomatous middle ear tumors are indolent in behavior, with a benign histologic appearance and slowly progressive growth. The mainstay of treatment is complete surgical resection, which affords the greatest likelihood of cure.

  20. Sandostatin (octreotide acetate) injection/Sandoz.

    PubMed

    Swartz, M L

    1990-01-01

    The potential benefits of Sandostatin represent an improvement in the quality of living for patients suffering from the symptoms of VIPomas and carcinoid tumors. These patients may have no other therapeutic alternative. Sandostatin may provide these patients with a well-tolerated treatment program that allows them to live a more natural lifestyle. Nurses must be aware of this medication and its administration in order to provide patients requiring Sandostatin therapy with the necessary instruction regarding its use.

  1. Mixed Adeno-neuroendocrine Carcinoma: An Aggressive Clinical Entity

    PubMed Central

    Brathwaite, Shayna; Rock, Jonathan; Yearsley, Martha M.; Bekaii-Saab, Tanios; Wei, Lai; Frankel, Wendy L.; Hays, John; Wu, Christina; Abdel-Misih, Sherif

    2016-01-01

    Background Mixed adeno-neuroendocrine carcinoma (MANEC) is a rare pathologic diagnosis recently defined by the World Health Organization in 2010. Due to poor understanding of MANEC as a clinical entity, there is significant variation in the management of these patients. The purpose of our study was to characterize MANEC to develop evidence-based treatment strategies. Methods The Ohio State University patient database was queried for the diagnosis of MANEC and 46 patients were identified. For comparison, the database also was queried for goblet cell carcinoid (GCC) of the appendix, signet ring cell carcinoma, and carcinoid/neuroendocrine tumor of the appendix. Charts were then retrospectively reviewed for clinicopathologic characteristics, patient treatment, and survival data. Results The mean age of diagnosis of MANEC was 54 years. Eighty-seven percent of MANEC arose from the appendix, with 28 % of patients undergoing appendectomy and 35 % undergoing right hemicolectomy as their index operation. Immunohistochemical staining was positive for chromogranin (82 %), synaptophysin (97 %), and CD56 (67 %). Sixty-seven percent of patients presented with stage IV disease and 41 % had nodal metastases. Overall survival was 4.1 years, which was statistically significantly different (p ≤ 0.05) compared with carcinoid tumors (13.4 years), GCC (15.4 years), and signet ring carcinoma (2.2 years). Conclusions MANEC is a more aggressive clinical entity than both GCC of the appendix and carcinoid/neuroendocrine tumors of the appendix. Based on these findings, we recommend patients with MANEC tumors undergo aggressive multidisciplinary cancer management and close surveillance. PMID:26965701

  2. Tracheal paraganglioma: an unusual neoplasm of the upper airway.

    PubMed

    Metzdorff, Mark T; Seaman, Joseph C; Opperman, David A; Goates, Jeffrey J; Musani, Ali I

    2012-05-01

    Paraganglioma of the trachea is a rare neoplasm, with fewer than 15 cases reported. A 40-year-old man presented with stridor and hemoptysis. Bronchoscopy demonstrated a tumor of the posterior trachea and biopsy initially suggested typical carcinoid. The patient underwent surgical resection uneventfully and made a good recovery. Final pathology disclosed the tumor to be a paraganglioma based on immunohistology. The pathophysiology and treatment of this tumor are discussed. PMID:22541208

  3. The Value of Somatostatin Receptor Imaging with In-111 Octreotide and/or Ga-68 DOTATATE in Localizing Ectopic ACTH Producing Tumors

    PubMed Central

    Gözde Özkan, Zeynep; Kuyumcu, Serkan; Balköse, Deniz; Özkan, Berker; Aksakal, Nihat; Yılmaz, Ebru; Şanlı, Yasemin; Türkmen, Cüneyt; Aral, Ferihan; Adalet, Işık

    2013-01-01

    Objective: We aimed to evaluate the value of somatostatin receptor imaging (SRI) with In-111 octreotide and Ga-68 DOTATATE in localizing ectopic ACTH producing tumors. Methods: Nineteen patients who had In-111 octreotide somatostatin receptor scintigraphy (SRS) and/or Ga-68 DOTATATE PET-CT to localize ectopic ACTH producing tumors between the years 2000 and 2012 were included retrospectively in our study. The results of SRI were compared with clinical onset, radiological findings and surgical data of the patients. Results: Sixteen In-111 octreotide SRS and five Ga-68 DOTATATE PET-CT were performed in 19 patients. In eight out of 19 patients, ectopic ACTH secretion site could be detected. In five patients, SRS showed pathologic uptake. In four of these patients, surgery revealed pulmonary carcinoid tumors and in one patient pancreatic neuroendocrine tumor. In one patient, Ga-68 DOTATATE PET-CT revealed pathologic uptake in lung nodule which came out to be pulmonary carcinoid tumor. In another patient who had resection of metastases of atypical carcinoid tumor prior to scans, new metastatic foci were detected both with SRS and Ga-68 DOTATATE PET-CT imaging. In one patient, although SRS was negative, CT which was performed three years later showed a lung nodule diagnosed as pulmonary carcinoid tumor. In 11 patients, ectopic ACTH secretion site could not be detected. In 10 of those patients, scintigraphic and radiological imaging did not show any lesions and in one patient, Ga-68 DOTATATE PET-CT was false positive. Conclusion: SRI has a complementary role with radiological imaging in localizing ectopic ACTH secretion sites. PET-CT imaging with Ga-68 peptide conjugates is a promising new modality for this indication. Conflict of interest:None declared. PMID:24003397

  4. EF5 and Motexafin Lutetium in Detecting Tumor Cells in Patients With Abdominal or Non-Small Cell Lung Cancer

    ClinicalTrials.gov

    2013-01-15

    Advanced Adult Primary Liver Cancer; Carcinoma of the Appendix; Fallopian Tube Cancer; Gastrointestinal Stromal Tumor; Localized Extrahepatic Bile Duct Cancer; Localized Gallbladder Cancer; Localized Gastrointestinal Carcinoid Tumor; Localized Resectable Adult Primary Liver Cancer; Localized Unresectable Adult Primary Liver Cancer; Metastatic Gastrointestinal Carcinoid Tumor; Ovarian Sarcoma; Ovarian Stromal Cancer; Primary Peritoneal Cavity Cancer; Recurrent Adult Primary Liver Cancer; Recurrent Adult Soft Tissue Sarcoma; Recurrent Colon Cancer; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Recurrent Gastric Cancer; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Non-small Cell Lung Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Small Intestine Cancer; Recurrent Uterine Sarcoma; Regional Gastrointestinal Carcinoid Tumor; Small Intestine Adenocarcinoma; Small Intestine Leiomyosarcoma; Small Intestine Lymphoma; Stage 0 Non-small Cell Lung Cancer; Stage I Adult Soft Tissue Sarcoma; Stage I Colon Cancer; Stage I Gastric Cancer; Stage I Non-small Cell Lung Cancer; Stage I Ovarian Epithelial Cancer; Stage I Ovarian Germ Cell Tumor; Stage I Pancreatic Cancer; Stage I Rectal Cancer; Stage I Uterine Sarcoma; Stage II Adult Soft Tissue Sarcoma; Stage II Colon Cancer; Stage II Gastric Cancer; Stage II Non-small Cell Lung Cancer; Stage II Ovarian Epithelial Cancer; Stage II Ovarian Germ Cell Tumor; Stage II Pancreatic Cancer; Stage II Rectal Cancer; Stage II Uterine Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage III Colon Cancer; Stage III Gastric Cancer; Stage III Ovarian Epithelial Cancer; Stage III Ovarian Germ Cell Tumor; Stage III Pancreatic Cancer; Stage III Rectal Cancer; Stage III Uterine Sarcoma; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Adult Soft Tissue Sarcoma; Stage IV Colon Cancer; Stage

  5. [Anaplastic tumor of the bladder with neurosecretory granules and benign courses].

    PubMed

    Vera-Román, J M; Arrufat Boix, J M

    1989-06-01

    We report on a 59-year-old female patient with a bladder tumor that was initially classified as anaplastic (undifferentiated) tumor. Posteriorly, electron microscopic and immunohistochemical analyses of the specimen revealed a neuroendocrine tumor distinct from a paraganglioma. The origin and prognosis of bladder carcinoids and small cell undifferentiated carcinomas are discussed. The authors indicate that the level of bladder wall infiltration is the most important prognostic parameter in these type of tumors.

  6. Epidemiology of cancer of the small intestine

    PubMed Central

    Pan, Sai Yi; Morrison, Howard

    2011-01-01

    Cancer of the small intestine is very uncommon. There are 4 main histological subtypes: adenocarcinomas, carcinoid tumors, lymphoma and sarcoma. The incidence of small intestine cancer has increased over the past several decades with a four-fold increase for carcinoid tumors, less dramatic rises for adenocarcinoma and lymphoma and stable sarcoma rates. Very little is known about its etiology. An increased risk has been noted for individuals with Crohn’s disease, celiac disease, adenoma, familial adenomatous polyposis and Peutz-Jeghers syndrome. Several behavioral risk factors including consumption of red or smoked meat, saturated fat, obesity and smoking have been suggested. The prognosis for carcinomas of the small intestine cancer is poor (5 years relative survival < 30%), better for lymphomas and sarcomas, and best for carcinoid tumors. There has been no significant change in long-term survival rates for any of the 4 histological subtypes. Currently, with the possible exceptions of obesity and cigarette smoking, there are no established modifiable risk factors which might provide the foundation for a prevention program aimed at reducing the incidence and mortality of cancers of the small intestine. More research with better quality and sufficient statistical power is needed to get better understanding of the etiology and biology of this cancer. In addition, more studies should be done to assess not only exposures of interest, but also host susceptibility. PMID:21461167

  7. Specific expression of OATPs in primary small cell lung cancer (SCLC) cells as novel biomarkers for diagnosis and therapy.

    PubMed

    Brenner, Stefan; Klameth, Lukas; Riha, Juliane; Schölm, Madeleine; Hamilton, Gerhard; Bajna, Erika; Ausch, Christoph; Reiner, Angelika; Jäger, Walter; Thalhammer, Theresia; Buxhofer-Ausch, Veronika

    2015-01-28

    The expression of organic anion transporting polypeptides (OATPs) was elucidated in cell lines from small cell lung cancer (SCLC) and lung carcinoids and in paraffin-embedded samples from primary and metastatic SCLCs. We found a strong relationship between OATP expression and the origin of the cells, as cells from primary or metastatic SCLC and carcinoid tumors differ with respect to OATP levels. OATP4A1 is most prominent in non-malignant lung tissue and in all SCLC and carcinoid cell lines and tissues, OATP5A1 is most prominent in metastatic cells, and OATP6A1 is most prominent in SCLC cell lines and tumors. Treatment with topotecan, etoposide and cisplatin caused significant changes in the expression patterns of OATP4A1, OATP5A1, OATP6A1, chromogranin and synaptophysin. This effect was also evident in GLC-14 cells from an untreated SCLC patient before chemotherapy compared to GLC-16/-19 chemoresistant tumor cells from this patient after therapy. mRNA expression of OATP4A1, 5A1 and 6A1 correlates with protein expression as confirmed by quantitative microscopic image analysis and Western blots. OATPs might be novel biomarkers for tumor progression and the development of metastasis in SCLC patients.

  8. Temsirolimus and Vinorelbine Ditartrate in Treating Patients With Unresectable or Metastatic Solid Tumors

    ClinicalTrials.gov

    2016-06-09

    Extensive Stage Small Cell Lung Cancer; Hereditary Paraganglioma; Male Breast Cancer; Malignant Paraganglioma; Metastatic Gastrointestinal Carcinoid Tumor; Metastatic Pheochromocytoma; Pancreatic Polypeptide Tumor; Recurrent Breast Cancer; Recurrent Cervical Cancer; Recurrent Endometrial Carcinoma; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Recurrent Neuroendocrine Carcinoma of the Skin; Recurrent Non-small Cell Lung Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pheochromocytoma; Recurrent Prostate Cancer; Recurrent Renal Cell Cancer; Recurrent Small Cell Lung Cancer; Recurrent Uterine Sarcoma; Regional Gastrointestinal Carcinoid Tumor; Regional Pheochromocytoma; Stage III Cervical Cancer; Stage III Endometrial Carcinoma; Stage III Neuroendocrine Carcinoma of the Skin; Stage III Ovarian Epithelial Cancer; Stage III Ovarian Germ Cell Tumor; Stage III Prostate Cancer; Stage III Renal Cell Cancer; Stage III Uterine Sarcoma; Stage IIIA Breast Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Breast Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer; Stage IV Endometrial Carcinoma; Stage IV Neuroendocrine Carcinoma of the Skin; Stage IV Non-small Cell Lung Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Prostate Cancer; Stage IV Renal Cell Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer; Thyroid Gland Medullary Carcinoma

  9. Restriction of dairy products; a reality in inflammatory bowel disease patients.

    PubMed

    Brasil Lopes, Mirella; Rocha, Raquel; Castro Lyra, André; Rosa Oliveira, Vanessa; Gomes Coqueiro, Fernanda; Silveira Almeida, Naiade; Santos Valois, Sandra; Oliveira Santana, Genoile

    2014-03-01

    Introducción: Se considera que la deficiencia de calcio es un factor de riesgo para el desarrollo de osteoporosis en pacientes con enfermedad inflamatoria intestinal (EII). En estos pacientes se han notificado diversas restricciones dietéticas. Objetivo: Evaluar la ingesta de productos lácteos y calcio de la dieta en pacientes con EII. Métodos: En este estudio cruzado se reclutaron 65 pacientes ambulatorios con EII procedentes de un centro de referencia para EII. Se administraron un cuestionario semi-estructurado (que recogía datos demográficos, socio- económicos y clínicos) y un cuestionario de frecuencia de consumo de alimento. Con respecto a los datos clínicos, evaluamos el estado nutricional antropométrico, la clasificación de la enfermedad, el índice de actividad de la enfermedad y la presencia de síntomas gastrointestinales. Se evaluaron las modificaciones auto-notificadas en el uso de los productos lácteos. Resultados: Las edades de los pacientes con EII variaban entre los 20 y 75 años y el 67,0% fueron diagnosticados de colitis ulcerosa. La mayoría (64,7 %) notificaban una restricción de los productos lácteos. La frecuencia de síntomas gastrointestinales fue mayor en los pacientes con enfermedad de Crohn que restringían los productos lácteos que en aquellos que no lo hacían (100% frente a 42,9%; p = 0,013); este resultado no se observó en los pacientes con colitis ulcerosa CU. La actividad de la enfermedad también fue más frecuente en los pacientes con EII que restringían los productos lácteos que en aquellos sin restricción (23,8% frente a 4,5%; p = 0,031) y, en los pacientes con CU, la enfermedad extensa fue más habitual en pacientes que restringían los productos lácteos que en aquellos que no lo hacían (42,9 % frente a 20,0%; p = 0,03). Conclusión: La restricción de productos lácteos es habitual en pacientes con EII, posiblemente debido a la actividad de la enfermedad, la presencia de síntomas gastrointestinales y la

  10. Understanding and Facing Discipline-Related Challenges in the English as a Foreign Language Classroom at Public Schools (Comprensión y tratamiento de los retos asociados a la disciplina en el aula de lengua extranjera en escuelas públicas)

    ERIC Educational Resources Information Center

    Quintero Corzo, Josefina; Ramírez Contreras, Odilia

    2011-01-01

    Complying with school regulations and teachers' instructions is a basic principle of an excellent class; both novice and experienced teachers face challenging situations when getting into real classrooms, especially those related to classroom management. There are various reasons that explain discipline problems in public schools, as well as…

  11. Seven-year survival after pancreaticoduodenectomy for early recurrent renal cell carcinoma involving the duodenum A case report.

    PubMed

    Cannistra', Marco; Ruggiero, Michele; Bonaiuto, Elisabetta; Vaccarisi, Sebastiano; Naso, Agostino; Grande, Raffaele; Nardo, Bruno

    2015-12-29

    Il cancro del rene rappresenta la 13a forma di tumore a livello mondiale e risulta incrementata, dal punto di vista epidemiologico, di circa il 2% annuo nelle ultime due decadi. Studi recenti hanno mostrato un numero complessivo di 65,150 nuovi casi di cancro renale diagnosticato nei paesi occidentali e circa 13.680 morti. Il carcinoma a cellule renali rappresenta approssimativamente il 90% di tutte le forme di cancro renale e presenta un tasso di mortalità di circa 4 soggetti ogni 100000 abitanti per anno. Il carcinoma a cellule renali ha, spesso, un particolare corteo sintomatologico caratterizzato da dolore addominale, masse addominali ed ematuria. Caratteristico è il fatto che circa il 25-30% dei pazienti, all’atto della diagnosi, presentano già metastasti a distanza; un ulteriore 30-50%, inoltre, svilupperanno metastasi nel corso della malattia, anche dopo molti anni dall’operazione chirurgica di nefrectomia radicale. Il Cancro del Rene a Cellule Chiare metastatizza in genere per via linfatica, ematogena, transperitoneale o per invasione diretta, ed i siti di metastasi più comuni sono il polmone ed i linfonodi, seguiti dalle ossa e dal fegato. Tra tutte le possibili localizzazioni ai segmenti addominali, il duodeno rappresenta la sede meno colpita: quando coinvolta, viene, in genere, invasa la regione periampollare ed il bulbo del duodeno. Tali localizzazioni danno segno di sè, spesso tardivamente, con sanguinamenti (ematemesi) o ostruzioni del tratto gastrointestinale superiore (vomito). Il nostro caso clinico descrive un carcinoma a cellule renali che si presentava, dopo soli 5 mesi dalla nefrectomia radicale destra, con sanguinamento del tratto gastrointestinale superiore e metastasi a carico del duodeno, e che è stato trattato chirurgicamente con duodenocefalopancreasectomia. L’intervento chirurgico, noto per essere altamente demolitivo ed associato ad elevata morbilità, applicato a recidiva precoce di cancro, ha garantito un ottimo risultato

  12. Efectos tardíos y el linfoma de Hodgkin en estadio inicial

    Cancer.gov

    Los pacientes con linfoma de Hodgkin en estadio inicial que recibieron varios fármacos de quimioterapia como único tratamiento, tenían más probabilidad de sobrevivir 12 años después que los pacientes que recibieron tratamiento que incluía radioterapia.

  13. Faltar a sesiones de radioterapia aumenta el riesgo de que regrese el cáncer

    Cancer.gov

    Pacientes que faltan a sesiones de radioterapia durante el tratamiento del cáncer tienen un riesgo mayor de que regrese su enfermedad, aun cuando eventualmente completen su plan de tratamiento con radiación, según un nuevo estudio.

  14. El dolor y el cáncer (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca del dolor como una complicación a causa del cáncer o su tratamiento. Se discuten enfoques sobre el manejo y tratamiento del dolor relacionado con el cáncer.

  15. Cáncer que regresa

    Cancer.gov

    El cáncer puede regresar cuando el tratamiento no elimina o destruye por completo todas las células cancerosas. Aprenda acerca de los diferentes tipos de recurrencia -recidiva- y cómo se vuelve a asignar un estadio al cáncer y se da tratamiento.

  16. Prurito (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca del prurito (picazón en la piel) como complicación del cáncer o su tratamiento. Se consideran los abordajes de manejo y tratamiento del prurito.

  17. Prurito (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca del prurito (picazón de la piel) como complicación del cáncer y su tratamiento. Se consideran los abordajes de manejo y tratamiento del prurito.

  18. Cannabis y canabinoides (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos sobre el uso del Cannabis y canabinoides para el tratamiento de los efectos secundarios relacionados con el tratamiento del cáncer como la náusea y el vómito.

  19. Cannabis y canabinoides (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos sobre el uso del Cannabis y canabinoides para el tratamiento de los efectos secundarios relacionados con el tratamiento del cáncer, como la náusea y el vómito.

  20. El dolor y el cáncer (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca del dolor como una complicación a causa del cáncer o su tratamiento. Se discuten enfoques sobre el manejo y tratamiento del dolor relacionado con el cáncer.

  1. Hacer frente - Supervivencia

    Cancer.gov

    Muchos supervivientes de cáncer dicen que cuando terminó el tratamiento, fue difícil ajustarse a una nueva forma de vida. Entérese de cómo ajustarse a nuevos sentimientos y problemas que aparecen después del tratamiento del cáncer.

  2. Cabozantinib y lenvatinib para cáncer renal

    Cancer.gov

    Artículo del blog del NCI sobre la aprobación reciente de la FDA de cabozantinib (Cabometyx®) y de lenvatinib (Lenvima®) para el tratamiento de pacientes cuyo cáncer avanzado de riñón ha evolucionado después de tratamiento con terapias antiangiogénicas.

  3. Biochemical diagnosis of neuroendocrine GEP tumor.

    PubMed Central

    Oberg, K.

    1997-01-01

    Neuroendocrine gut and pancreatic tumors are known to contain and secret different peptide hormones and amines. During the last two decades, many radioimmunoassays and Elizas have been developed to analyze these substances in blood and urine, which has enabled clinicians to improve the diagnosis and monitoring of patients with various neuroendocrine tumors. Due to cost constraints in medical care, it is important to try to define the most useful biochemical markers from the clinical point of view. The glycoprotein chromogranin A has been shown to be a useful marker for diagnosing various neuroendocrine tumors, both by histopathology and circulating tumor markers. In patients with demonstrable endocrine tumors, about 90 percent of the patients present high circulating levels of chromogranin A. A hundred-fold increase of plasma chromogranin is seen in patients with midgut carcinoid tumors and liver metastases. The plasma levels of chromogranin A reflect the tumor mass and can be used for monitoring the patient during treatment and follow-up, although the day-to-day variation might be 30-40 percent. High circulating levels of the chromogranin A might be an indicator of bad prognosis in patients with malignant carcinoid tumors. Besides analyzing plasma chromogranin A, specific analyses such as urinary 5-HIAA in midgut carcinoid patients, serum gastrin in patients with Zollinger-Ellison syndrome and insulin/proinsulin in patients with hypoglycemia should be performed. In patients with small tumor masses or intermittent symptoms, provocative tests such as a meal stimulation test, secretin test or pentagastrin stimulation of tachykinin release can supplement the basal measurements of peptides and amines. To fully evaluate the growth potential in neuroendocrine tumors, traditional biochemical markers should be supplemented with indicators of growth proliferation (Ki-67, PCNA) and immunohistochemical staining for the adhesion molecule CD44 and the PDGF-alpha receptor

  4. Routine histopathologic examination of appendectomy specimens: retrospective analysis of 1255 patients.

    PubMed

    Emre, Arif; Akbulut, Sami; Bozdag, Zehra; Yilmaz, Mehmet; Kanlioz, Murat; Emre, Rabia; Sahin, Nurhan

    2013-01-01

    The objective of this study was to analyze the clinical benefit of histopathologic analysis of appendectomy specimens from patients with an initial diagnosis of acute appendicitis. We retrospectively analyzed the demographic and histopathologic data of 1255 patients (712 males, 543 females; age range, 17-85 years) who underwent appendectomy to treat an initial diagnosis of acute appendicitis. Patients who underwent incidental appendectomy during other surgeries were excluded from the study. Histopathologic findings of the appendectomy specimens were used to confirm the initial diagnosis. Ninety-four percent of the appendectomy specimens were positive for appendicitis. Of those, 880 were phlegmonous appendicitis, 148 were gangrenous appendicitis with perforation, and the remaining 88 showed unusual histopathologic findings. In the 88 specimens with unusual pathology, fibrous obliteration was observed in 57 specimens, carcinoid tumor in 11, Encheliophis vermicularis parasite infection in 8, granulatomous inflammation in 6, appendiceal endometriosis in 2, and 1 specimen each showed mucocele, eosinophilic infiltration, Taenia saginata parasite infection, and appendicular diverticulitis. All carcinoid tumors were located in the distal appendix. Six of the 11 carcinoid tumors were defined by histopathology as involving tubular cells, and the other 5 as involving enterochromaffin cells. Six patients had muscularis propria invasion, 2 patients had submucosa invasion, 2 patients had mesoappendix invasion, and 1 patient had serosal invasion. All patients with tumors remained disease free during the follow-up (range, 1-27 months). We conclude that when the ratio of unusual pathologic findings for appendectomy specimens is considered, it is evident that all surgical specimens should be subjected to careful histologic examination. PMID:24229023

  5. Severe hypokalemia, metabolic alkalosis and hypertension in a 54 year old male with ectopic ACTH syndrome: a case report.

    PubMed

    Martínez-Valles, Miguel Angel; Palafox-Cazarez, Asael; Paredes-Avina, Jose Antonio

    2009-01-01

    Ectopic ACTH syndrome is a rare cause of Cushing's syndrome accounting for about 15% of all cases. Small cell lung cancer and bronchial carcinoids account for about half of the cases. Malignant neoplasm has rapid and more aggressive metabolic effects. We report a 54-year-old male patient with phenotypic features of Cushing's syndrome with severe hypokalemia, metabolic alkalosis, hypertension and altered mental status as manifestations of an ACTH-secreting small cell carcinoma from the lung. Ectopic ACTH syndrome should be highly considered in patients with hypertension and severe hypokalemic metabolic alkalosis, especially when a lung mass is discovered. PMID:19829770

  6. Diagnosing a Gastric Submucosal Tumor Using Jumbo Biopsy “Unroofing” Technique: A Case Report and Review of the Literature

    PubMed Central

    Kapur, Sakshi; Mahal, Pradeep; Miles, Levin; Hussain, Adnan

    2013-01-01

    We report a case of a 40-year-old female who presented with dyspeptic symptoms for six months. Upper GI endoscopy revealed a submucosal nodule in gastric antrum. Using “jumbo biopsy unroofing technique” we were able to get adequate tissue for analysis. Histopathology revealed a type III gastric carcinoid. Patient was treated with laparoscopic distal subtotal gastrectomy with Roux-en-Y reconstruction and partial omentectomy. Although there was no evidence of metastasis on initial presentation, eighteen months later, patient was found to have multiple metastatic lesions in her liver. Patient's lesions were treated with intra-arterial (hepatic artery) Yttrium-90. PMID:24349809

  7. Diagnosing a gastric submucosal tumor using jumbo biopsy "unroofing" technique: a case report and review of the literature.

    PubMed

    Kapur, Sakshi; Mahal, Pradeep; Miles, Levin; Hussain, Adnan

    2013-01-01

    We report a case of a 40-year-old female who presented with dyspeptic symptoms for six months. Upper GI endoscopy revealed a submucosal nodule in gastric antrum. Using "jumbo biopsy unroofing technique" we were able to get adequate tissue for analysis. Histopathology revealed a type III gastric carcinoid. Patient was treated with laparoscopic distal subtotal gastrectomy with Roux-en-Y reconstruction and partial omentectomy. Although there was no evidence of metastasis on initial presentation, eighteen months later, patient was found to have multiple metastatic lesions in her liver. Patient's lesions were treated with intra-arterial (hepatic artery) Yttrium-90.

  8. Iodine-131 MIBG uptake in metastatic medullary carcinoma of the thyroid. A patient treated with somatostatin

    SciTech Connect

    Keeling, C.A.; Basso, L.V.

    1988-04-01

    A 47-year-old man with multiple endocrine neoplasia (MEN) type 2a syndrome in whom metaiodobenzylguanidine (MIBG) concentrated in lesions from metastatic medullary carcinoma of the thyroid is reported. A somatostatin analogue (Sandostatin SMS 201-995) alleviated the symptoms of flushing and diarrhea associated with the elevated calcitonin levels but it did not alter either the course of the disease or the MIBG images. A review of the literature is presented of the noncatecholamine secreting tumors associated with MIBG uptake. Similarities between this case and metastatic carcinoid syndrome are discussed. 27 references.

  9. Mucinous adenocarcinoma of the appendix presenting with atypical symptomatology and presence of pseudomyxoma peritonei: a case report

    PubMed Central

    2009-01-01

    Introduction Primary tumors of the appendix are unusual and most of them are carcinoids. Their main presentation is that of an acute appendicitis or as a palpable mass, mainly in the right lower quadrant. Case presentation A female patient with mucous adenocarcinoma of the appendix, which primarily presented as atypical abdominal pain. Diagnosis of the disease was made after appendicectomy and histopathological analysis of the specimen. The patient finally underwent a complementary right hemicolectomy. Conclusion Mucin producing adenocarcinomas of the appendix are a category of rare cancers of the gastrointestinal tract. Although at present they are a well studied pathologic entity, the crucial issue of their preoperative diagnosis remains unsolved. PMID:20062726

  10. Pathology, pathophysiology, and treatment strategies of endocrine disorders and their cardiac complications.

    PubMed

    Luk, Adriana; Ezzat, Shereen; Butany, Jagdish

    2013-08-01

    The cardiovascular system is affected by a multitude of endocrine disorders, including dysfunction of the thyroid, calcium, glucocorticoids, insulin/glucose, and growth hormone axes. Since most of these changes in the cardiovascular system are reversible when treated, early diagnosis is important, as if left untreated, they may become fatal. This review focuses on the pathophysiology, clinical presentation, pathology, and treatment of patients with these endocrine diseases who present with a variety of cardiovascular manifestations. Neuroendocrine tumors presenting with the carcinoid syndrome and their cardiovascular manifestations are also discussed. PMID:24144293

  11. Severe hypokalemia, metabolic alkalosis and hypertension in a 54 year old male with ectopic ACTH syndrome: a case report

    PubMed Central

    Palafox-Cazarez, Asael; Paredes-Avina, Jose Antonio

    2009-01-01

    Ectopic ACTH syndrome is a rare cause of Cushing’s syndrome accounting for about 15% of all cases. Small cell lung cancer and bronchial carcinoids account for about half of the cases. Malignant neoplasm has rapid and more aggressive metabolic effects. We report a 54-year-old male patient with phenotypic features of Cushing’s syndrome with severe hypokalemia, metabolic alkalosis, hypertension and altered mental status as manifestations of an ACTH-secreting small cell carcinoma from the lung. Ectopic ACTH syndrome should be highly considered in patients with hypertension and severe hypokalemic metabolic alkalosis, especially when a lung mass is discovered. PMID:19829770

  12. Multidisciplinary management of nonfunctional neuroendocrine tumor of the pancreas

    PubMed Central

    Folkert, Ian W; Hernandez, Paul; Roses, Robert E

    2016-01-01

    Pancreatic neuroendocrine tumors (PNETs) are a rare and diverse group of tumors; nonfunctional (NF) PNETs account for the majority of cases. Most patients with NF-PNETs have metastatic disease at the time of presentation. A variety of treatment modalities exist, including medical, liver directed, and surgical treatments. Aggressive surgical management is associated with prolonged survival, however available data are limited by selection bias and the frequent combination of PNETs with carcinoid tumors. Although few patients with metastatic disease will be cured, application of currently available therapies in a multidisciplinary setting can lead to excellent outcomes with prolonged patient survival. PMID:27003988

  13. Pathology, pathophysiology, and treatment strategies of endocrine disorders and their cardiac complications.

    PubMed

    Luk, Adriana; Ezzat, Shereen; Butany, Jagdish

    2013-08-01

    The cardiovascular system is affected by a multitude of endocrine disorders, including dysfunction of the thyroid, calcium, glucocorticoids, insulin/glucose, and growth hormone axes. Since most of these changes in the cardiovascular system are reversible when treated, early diagnosis is important, as if left untreated, they may become fatal. This review focuses on the pathophysiology, clinical presentation, pathology, and treatment of patients with these endocrine diseases who present with a variety of cardiovascular manifestations. Neuroendocrine tumors presenting with the carcinoid syndrome and their cardiovascular manifestations are also discussed.

  14. 68Ga-DOTATATE Breast Uptake and Expression in Breast Milk.

    PubMed

    Forwood, Nicholas J; Kanthan, Gowri L; Bailey, Dale L; Chan, David L; Schembri, Geoffrey P

    2016-08-01

    The excretion of Ga-DOTA-Octreotate (DOTATATE) and related somatostatin analogues in breast milk has not been demonstrated. We report a case of a 34-year-old woman, 7 months postpartum and breastfeeding, who was referred for DOTATATE imaging after the diagnosis of appendiceal carcinoid and subsequent appendectomy. Prominent breast uptake was noted. A breast milk sample from the patient at 90 minutes postinjection was assayed in a gamma counter and shown to have a concentration of 5.6 Bq/g per MBq administered. The excretion of DOTATATE in breast milk is important to consider when providing radiation safety advice to breastfeeding patients. PMID:27276203

  15. [Experience of off-label use of Eltrombopag in the treatment of thrombocytopenia associated with solid tumors].

    PubMed

    García Lagunar, María Henar; Cerezuela Fuentes, Pablo; Martínez Penella, Mónica; Gutiérrez-Meca Maestre, Dolores Paula; García Coronel, María; Martínez Ortiz, María José

    2015-05-01

    Objetivo: Describir los resultados del uso fuera de indicación de eltrombopag en pacientes con trombocitopenia limitante de tratamiento quimioterápico y tumores sólidos. Método: Estudio observacional retrospectivo en el que se incluyeron todos los pacientes con tumores sólidos tratados con eltrombopag por trombocitopenia durante el tratamiento con quimioterapia entre enero de 2012 y diciembre de 2014. Resultados: Seis pacientes, con tumores sólidos y trombocitopenia limitante de tratamiento, recibieron eltrombopag durante el periodo de estudio con una disminución en el retraso de ciclos de quimioterapia (4,83 ± 4,79 ciclos retrasados antes del inicio de eltrombopag vs 2,50 ± 4,32 ciclos durante el tratamiento con eltrombopag, p=0,492) y un aumento en el porcentaje de dosis real administrada (89,29 ± 13,36% vs 91,43 ± 10,69%, p=0,682). Así mismo, se produjo un aumento en el nadir de plaquetas (55,29 ± 16,45x109/L vs 76,14 ± 36,38x109/L, p=0,248) sin requerir en ningún paciente soporte transfusional con plaquetas durante el tratamiento con eltrombopag. Conclusiones: eltrombopag ha resultado ser una alternativa de tratamiento para pacientes con trombocitopenia limitante de tratamiento con quimioterapia, siendo necesarios ensayos clínicos con mayor número de pacientes que confirmen estos resultados.

  16. [National consensus on the ketogenic diet].

    PubMed

    Armeno, Marisa; Caraballo, Roberto; Vaccarezza, María; Alberti, M Julia; Ríos, Viviana; Galicchio, Santiago; de Grandis, Elizabeth S; Mestre, Graciela; Escobal, Nidia; Matarrese, Pablo; Viollaz, Rocío; Agostinho, Ariela; Díez, Cecilia; Cresta, Araceli; Cabrera, Analía; Blanco, Virginia; Ferrero, Hilario; Gambarini, Victoria; Sosa, Patricia; Bouquet, Cecilia; Caramuta, Luciana; Guisande, Silvina; Gamboni, Beatriz; Hassan, Amal; Pesce, Laura; Argumedo, Laura; Dlugoszewski, Corina; DeMartini, Martha G; Panico, Luis

    2014-09-01

    Introduccion. La epilepsia es una enfermedad cronica que afecta al 0,5-1% de la poblacion, mayormente de inicio durante la infancia. Un tercio de los pacientes evoluciona hacia una forma refractaria al tratamiento con farmacos antiepilepticos, lo que plantea al equipo de salud un desafio terapeutico. La dieta cetogenica (DC) es un tratamiento no farmacologico efectivo utilizado como un metodo alternativo para el tratamiento de la epilepsia refractaria. Objetivos. Es necesario establecer directrices para utilizar la DC adecuadamente y asi expandir su conocimiento y utilizacion en paises hispanoparlantes. El Comite Nacional de Dieta Cetogenica, dependiente de la Sociedad Argentina de Neurologia Infantil, elaboro este consenso para estandarizar el uso de la DC basandose en la bibliografia publicada y la experiencia clinica. El grupo esta formado por neuropediatras, medicos nutricionistas y licenciadas en nutricion de cinco provincias de Argentina pertenecientes a 10 centros que aplican la DC como tratamiento de la epilepsia refractaria. Desarrollo. Se exponen temas tales como la seleccion del paciente, el asesoramiento a la familia antes del tratamiento, las interacciones de la DC con la medicacion anticonvulsionante, los suplementos, el control de efectos adversos y la retirada de dicha dieta. Conclusiones. La DC es un tratamiento util para los pacientes pediatricos con epilepsia intratable. Es fundamental la educacion y colaboracion del paciente y la familia. El tratamiento debe llevarlo a cabo un equipo interdisciplinar experimentado, siguiendo un protocolo. La formacion de un grupo nacional interdisciplinar, y la publicacion de este consenso, ofrece la posibilidad de orientar a nuevos centros en su implantacion.

  17. Acquired haemophilia A in a patient with chronic hepatitis C virus infection receiving treatment with pegylated interferon plus ribarivin: role of rituximab.

    PubMed

    Fernández de Palencia Espinosa, M Á; Arocas Casañ, V; Garrido Corro, B; de la Rubia Nieto, A

    2013-01-01

    Antecedentes: la hemofilia adquirida es un trastorno infrecuente causado por el desarrollo de inhibidores del factor de coagulación. Para eliminarlos, se requiere tratamiento con corticoides y fármacos citotóxicos. Métodos: describimos el caso del uso de rituximab en hemofilia adquirida refractaria al tratamiento convencional en un hombre de 63 años con infección crónica por el virus de la hepatitis C y que estaba recibiendo tratamiento con interferón pegilado a-2a y ribarivina. Resultados: tras 21 semanas de tratamiento antivírico, el paciente fue ingresado en el hospital por un gran hematoma en la musculatura abdominal. La concentración de factor VIII era nula y el título de inhibidor fue de 345 unidades Bethesda. Se administró tratamiento inmunosupresor oral con metilprednisolona y ciclofosfamida durante 1 mes, con escasa mejoría. Así pues, se sustituyó la ciclofosfamida por una dosis semanal de rituximab intravenoso. Dos meses después, la concentración de factor VIII se normalizó y el título de inhibidor era indetectable. Conclusión: Rituximab puede ser útil en el tratamiento de la hemofilia adquirida resistente al tratamiento estándar.

  18. [Efficacy of lisdexamphetamine to improve the behavioural and cognitive symptoms of attention deficit hyperactivity disorder: treatment monitored by means of the AULA Nesplora virtual reality test].

    PubMed

    Diaz-Orueta, U; Fernandez-Fernandez, M A; Morillo-Rojas, M D; Climent, G

    2016-07-01

    Introduccion. La lisdexanfetamina (LDX) es el farmaco para el trastorno por deficit de atencion/hiperactividad (TDAH) con mayor volumen de investigacion de los ultimos años. No obstante, no hay estudios que certifiquen su utilidad para la mejoria del funcionamiento cognitivo en el TDAH. Objetivo. Evaluar la eficacia de la LDX en la mejora sintomatica conductual y cognitiva en un grupo de pacientes con TDAH. Dicha eficacia fue medida mediante la administracion del test AULA Nesplora de realidad virtual antes de la prescripcion del tratamiento farmacologico y despues del tratamiento con LDX. Pacientes y metodos. La muestra estaba compuesta por 85 pacientes de 6-16 años, con diagnostico clinico de TDAH y que asistian a tratamiento en una consulta de neuropediatria. Todos los pacientes iniciaron el tratamiento farmacologico con la correspondiente dosis de LDX tras la entrevista clinica y la primera administracion del test AULA. Tras un tratamiento medio de 7,5 meses, se les administro AULA nuevamente y se valoro el progreso del tratamiento farmacologico sobre la sintomatologia cognitiva y motora. Resultados. Se apreciaron mejorias muy significativas en la atencion selectiva y sostenida, la calidad del foco atencional y la hiperactividad, mejorias moderadas en la impulsividad, y una incidencia casi nula en la velocidad de procesamiento. Conclusiones. La LDX constituye un tratamiento adecuado para la mejora sustancial de la atencion e hiperactividad, y dicha mejora puede monitorizarse de forma precisa mediante el test de realidad virtual AULA.

  19. [Adherence to oral antineoplastic therapy].

    PubMed

    Olivera-Fernandez, R; Fernandez-Ribeiro, F; Piñeiro-Corrales, G; Crespo-Diz, C

    2014-11-03

    Introducción: Los tratamientos antineoplasicos orales presentan ventajas en cuanto a coste, comodidad y mejora potencial en la calidad de vida respecto al tratamiento endovenoso, pero es mas dificil controlar la adherencia y monitorizar los efectos adversos. El objetivo de este estudio fue conocer la adherencia real en pacientes con antineoplasicos orales en nuestro centro, analizar la influencia de las caracteristicas del paciente y del tratamiento, identificar motivos de no adherencia, oportunidades de mejora en la atencion farmaceutica y evaluar la posible relacion adherencia y respuesta al tratamiento. Método: estudio prospectivo observacional de cuatro meses de duracion, en los pacientes con tratamiento antineoplasico oral dispensado desde la consulta de farmacia oncologica. Para la recogida de datos se utilizaron: orden medica, historia clinica y visita con entrevistas al paciente. Resultados: Se evaluaron un total de 141 pacientes. Un 72% se considero totalmente adherente, mientras que en un 28% se detecto algun tipo de no adherencia. El tiempo desde el diagnostico y la presencia de efectos adversos fueron las variables que afectaron a la adherencia. No se pudo demostrar relacion entre adherencia y respuesta al tratamiento. Conclusiones: La adherencia al tratamiento antineoplasico oral en nuestro centro fue del 72%, identificando oportunidades de mejora en la atencion farmaceutica dirigidas a prevenir los efectos adversos y a potenciar la adherencia de nuestros pacientes.

  20. [Effectiveness of lacosamide in the treatment of refractory neuropathic pain: an open observational trial].

    PubMed

    Gómez-Argüelles, José M; Bermejo, Pedro E; Lara, Manuel; Almajano, Jerónimo; Aragón, Esther; García del Carrizo, Fernando; Blanco, M Victoria; Valenzuela-Rojas, Francisco J; Colás, Juan; Sánchez-Del Valle, Octavio; Ceballos, M Ángeles; Toribio-Díaz, M Elena; Latorre-González, Germán; Costa-Frossard, Lucienne; Morin-Martin, M del Mar

    2014-10-01

    Introduccion. Aunque se dispone de diferentes tratamientos para el dolor neuropatico, en muchas ocasiones estos pacientes son refractarios, lo que hace necesario probar tratamientos que, por su utilidad en otras patologias, podrian ser eficaces en el dolor neuropatico. Pacientes y metodos. Se recogieron las historias clinicas de pacientes que hubieran sido tratados con lacosamida para el dolor neuropatico, en diferentes hospitales de la zona centro peninsular, y que cumplieran unas caracteristicas similares en cuanto a refractariedad a otros tratamientos estandares, en un seguimiento de al menos seis meses, o que hubiesen tenido que suspender el tratamiento con dicho farmaco por cualquier motivo. Se obtuvo una muestra de 114 pacientes, 61 varones y 53 mujeres, con una edad media de 60,5 años. Resultados. Las causas de dolor neuropatico mas frecuentes fueron: polineuropatia diabetica (31,6%), neuralgia postherpetica (22,8%), neuralgia del trigemino (17,5%), neuralgia suboccipital y lumbociatalgia (un 12,3% en ambas). La eficacia fue buena/muy buena en la mayoria de los pacientes, con un descenso medio en la escala analogica visual tras seis meses de 7,7 a 4,8. No se registraron efectos secundarios graves en ningun paciente, pero en 12 y 10 pacientes no hubo registro mas alla de seis meses, por ineficacia e intolerancia al tratamiento, respectivamente. Conclusiones. El tratamiento con lacosamida en el dolor neuropatico de diferentes causas podria considerarse como una alternativa efectiva y bien tolerada para aquellos pacientes que no respondan a los tratamientos estandares.

  1. [Compliance of the guidelines of the Spanish Neurology Society in the treatment of patients with multiple sclerosis].

    PubMed

    Oreja-Guevara, Celia; Río, Jordi; Gobartt, Ana L

    2015-08-16

    Introduccion. El tratamiento de la esclerosis multiple se basa en la administracion de farmacos modificadores de la enfermedad (FAME), utilizados para frenar el curso natural de la enfermedad. Objetivo. Evaluar el grado de cumplimiento de las guias terapeuticas de la Sociedad Española de Neurologia (SEN) de 2010 por parte de los neurologos. Pacientes y metodos. Estudio observacional, retrospectivo y multicentrico de 218 pacientes adultos con esclerosis multiple de al menos cinco años de evolucion y en tratamiento con FAME. Los datos se obtuvieron de la historia clinica y se compararon con las recomendaciones de la SEN. Resultados. Segun las guias de la SEN de 2010, el 82% de los pacientes presentaba respuesta clinica adecuada, y el 18%, respuesta clinica inadecuada al FAME actual; el 94% y 92%, respectivamente, mantuvieron ese tratamiento. Los pacientes en los que la respuesta clinica inadecuada no origino un cambio del FAME actual llevaban en tratamiento mas tiempo y experimentaron con mayor frecuencia progresion de su discapacidad e incremento del numero de brotes. El 48% de los pacientes inicio tratamiento de primera linea con interferon beta-1a, administrado por via subcutanea (29%) o intramuscular (19%), seguido de interferon beta-1b y acetato de glatiramero. Algunos pacientes recibieron tratamientos de segunda linea como segunda/tercera opcion (15% y 28%, respectivamente), pero el uso de estos tratamientos (especialmente natalizumab) solo se generalizo a partir de la cuarta linea de tratamiento. Conclusiones. De acuerdo con las guias de la SEN de 2010, la mayoria de los pacientes tuvo una respuesta clinica adecuada. Un elevado porcentaje de pacientes con respuesta clinica inadecuada continuo con el tratamiento actual.

  2. INSL5 is a novel marker for human enteroendocrine cells of the large intestine and neuroendocrine tumours.

    PubMed

    Thanasupawat, Thatchawan; Hammje, Katrin; Adham, Ibrahim; Ghia, Jean-Eric; Del Bigio, Marc R; Krcek, Jerry; Hoang-Vu, Cuong; Klonisch, Thomas; Hombach-Klonisch, Sabine

    2013-01-01

    We report for the first time the distribution of human INSL5 and its cognate leucine rich G-protein coupled receptor RXFP4 in the large intestine and in neuroendocrine/carcinoid tissues. Immunoreactive INSL5 was uniquely expressed by enteroendocrine cells (EECs) located within the colonic mucosa, whereas colonocytes were immunopositive for RXFP4. INSL5+ and RXFP4+ cells were also detected in human neuroendocrine/carcinoid tissues. We employed a recently described Insl5 knockout mouse model and 2 mouse models of induced colitis to address the relevance of Insl5 in EEC development and in acute inflammation of the colon. We identified INSL5 as a specific marker for synaptophysin+ EECs in the mucosa of the normal human and mouse colon. Insl5 was not essential for the development of mouse synaptophysin+ EECs. The mouse models of chemically induced colitis (dextran sulfate sodium and dinitrobenzene-sulfonic acid) failed to show changes in the numbers of Insl5+ EECs at inflammatory sites during the acute phase of colitis. In conclusion, we showed that INSL5 is a novel marker of colorectal EECs and provide first evidence for the presence of a potentially autocrine/paracrine INSL5-RXFP4 signaling system in the normal human and mouse colon and in rare human neuroendocrine tumours.

  3. Approach to the endoscopic resection of duodenal lesions

    PubMed Central

    Gaspar, Jonathan P; Stelow, Edward B; Wang, Andrew Y

    2016-01-01

    Duodenal polyps or lesions are uncommonly found on upper endoscopy. Duodenal lesions can be categorized as subepithelial or mucosally-based, and the type of lesion often dictates the work-up and possible therapeutic options. Subepithelial lesions that can arise in the duodenum include lipomas, gastrointestinal stromal tumors, and carcinoids. Endoscopic ultrasonography with fine needle aspiration is useful in the characterization and diagnosis of subepithelial lesions. Duodenal gastrointestinal stromal tumors and large or multifocal carcinoids are best managed by surgical resection. Brunner’s gland tumors, solitary Peutz-Jeghers polyps, and non-ampullary and ampullary adenomas are mucosally-based duodenal lesions, which can require removal and are typically amenable to endoscopic resection. Several anatomic characteristics of the duodenum make endoscopic resection of duodenal lesions challenging. However, advanced endoscopic techniques exist that enable the resection of large mucosally-based duodenal lesions. Endoscopic papillectomy is not without risk, but this procedure can effectively resect ampullary adenomas and allows patients to avoid surgery, which typically involves pancreaticoduodenectomy. Endoscopic mucosal resection and its variations (such as cap-assisted, cap-band-assisted, and underwater techniques) enable the safe and effective resection of most duodenal adenomas. Endoscopic submucosal dissection is possible but very difficult to safely perform in the duodenum. PMID:26811610

  4. Diagnosis and treatment of neuroendocrine lung tumors.

    PubMed

    Sánchez de Cos Escuín, Julio

    2014-09-01

    Pulmonary neuroendocrine tumors (PNT) encompass a broad spectrum of tumors including typical carcinoid (TC) and atypical (AC) tumors, large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC). Although no variety can be considered benign, AC and TC have a much lower metastatic potential, are usually diagnosed in early stages, and most are candidates for surgical treatment. Several chemotherapy (CT) regimens are available in the case of recurrence or in advanced stages, although scientific evidence is insufficient. LCNEC, which is currently classified alongside large-cell carcinomas, have molecular features, biological behavior and CT sensitivity profile closely resembling SCLC. Pathological diagnosis is often difficult, despite the availability of immunohistochemical techniques, and surgical specimens may be necessary. The diagnostic tests used are similar to those used in other lung tumors, with some differences in the optimal tracer in positron emission tomography. The new TNM classification is useful for staging these tumors. Carcinoid syndrome, very rare in PNT, may cause symptoms that are difficult to control and requires special therapy with somatostatin analogs and other drugs. Overall, with the exception of SCLC, new trials are needed to provide a response to the many questions arising with regard to the best treatment in each lineage and each stage.

  5. Quantitative nuclear texture features analysis confirms WHO classification 2004 for lung carcinomas.

    PubMed

    Schmid, Katharina; Angerstein, Nina; Geleff, Silvana; Gschwendtner, Andreas

    2006-03-01

    The purpose of this study was to discriminate the main subsets of lung carcinomas of the WHO classification of 2004 by nuclear chromatin texture feature analysis. Our collective comprised 56 typical and 19 atypical carcinoids, 37 small-cell carcinomas, 15 large-cell neuroendocrine carcinomas, 42 adenocarcinomas, and 26 squamous cell carcinomas. After Feulgen staining, cell nuclei were automatically measured using a high-resolution image analyser (CytoSavant Oncometrics, Vancouver, BC, Canada). Texture features describing the granularity and the compactness of the nuclear chromatin were extracted for calculation of classification rules, which allowed the discrimination of different tumor groups. By applying the classification rule that described the granularity of the nuclear chromatin (defined by four different parameters) small-cell and non-small-cell lung carcinoma could correctly be discriminated in 93%. No significant discrimination was possible between the different subtypes of large-cell carcinomas, including large-cell neuroendocrine carcinoma. When using compactness of chromatin (defined by four texture parameters) as a means of discrimination, carcinoids and non-small-cell lung carcinomas were correctly distinguished in 92%. No significant discrimination between neuroendocrine tumors was achieved though. Our findings are in accordance with the new WHO classification of 2004: neuroendocrine tumors of the lung are now classified according only to their mitotic counts and presence of necrosis but not by their morphology; their discrimination by the means of nuclear image analysis is not sufficient and therefore not appropriate any longer. PMID:16462732

  6. Primary ovarian neuroendocrine tumor arising in association with a mature cystic teratoma: A case report.

    PubMed

    Orsi, Nicolas M; Menon, Mini

    2016-08-01

    Primary ovarian carcinoid tumors are exceptionally rare entities accounting for approximately 0.1% of all ovarian neoplasms. This report describes a primary ovarian neuroendocrine tumor arising in association with a mature cystic teratoma in a 65 year-old woman. Macroscopically, the unilateral adnexal tumor was composed of cystic, solid and mucinous elements which resolved into a dual component lesion histologically. The majority of the tumor displayed an organoid architecture with mild to moderate pleomorphism and no discernible mitotic activity, while approximately 10% consisted of sheets and groups of cells with highly pleomorphic nuclei, necrosis and occasional mitoses. Features of a mature cystic teratoma were seen very focally. Immunohistochemistry revealed strong, diffuse positivity for CD56 and synaptophysin. Chromogranin immunonegativity was noted and there was an absence of nuclear β-catenin accumulation. Ki-67 index was 10-12%. Although there is no established diagnostic framework for primary ovarian carcinoid tumors, this case was diagnosed as a well-differentiated neuroendocrine tumor, Grade 2 (intermediate grade), arising in association with a mature cystic teratoma/dermoid cyst. This case highlights the need to develop ovarian diagnostic criteria in this area. PMID:27508272

  7. [Grading of neuroendocrine tumors].

    PubMed

    Saeger, W; Schnabel, P A; Komminoth, P

    2016-07-01

    The current WHO classification of neuroendocrine tumors (NET) differentiates between typical carcinoids (low grade NET), atypical carcinoids (intermediate grade NET) and small cell and large cell carcinomas (high grade NET) according to the prognosis. Neuroendocrine neoplasms (NEN) of the gastrointestinal tract and the pancreas are graded in an identical way. Together with the TNM system this enables a preoperative estimation of the prognosis in biopsies and fine needle aspirates. Well-differentiated tumors are graded into G1 tumors by the number of mitoses, <2 per 10 high-power fields (HPF) and the Ki-67 (index <3 %) and G2 tumors (2-20 mitoses/10 HPF, Ki-67 3-20 %). Discrepancies between the number of mitoses and the Ki-67 index are not uncommon and in these cases the higher value of the two should be applied. The more differentiated tumors of the G3 type have to be differentiated from undifferentiated carcinomas of the small cell type and large cell type with a much poorer prognosis. Prognosis relevant grading of thyroid cancers is achieved by special subtyping so that the G1-G3 system is not applicable. The rare cancers of the parathyroid gland and of the pituitary gland are not graded. Adrenal tumors also have no grading system. The prognosis is dependent on the Ki-67 index and with some reservations on the established scoring systems. PMID:27379621

  8. Primary pulmonary neoplasms in children: A report of five cases

    PubMed Central

    Sengupta, Subhalakshmi; Chatterjee, Uttara; Bandyopadhyay, Ranjana; Bhowmick, Kuntal; Banerjee, Sugata

    2011-01-01

    Primary pulmonary neoplasms are uncommon in children and represent a wide spectrum of pathology from benign to malignant. They are quite different in their histopathologic distribution from that of adults. This study was done to analyze the histopathologic spectrum of primary lung tumors in children. All the resected specimens of lung in children over a period of 5 years were studied and only the cases of primary pulmonary neoplasms were further analyzed. There were two cases of inflammatory myofibroblastic tumor. The patients were boys aged 10 and 12 years, respectively. One case of bronchial carcinoid was diagnosed in a boy of 12 years. There were one case each of pleuropulmonary blastoma (PPB) in a girl of 9 years and pulmonary blastoma (PB) in a girl of 2 years of age. In our study, the two cases of inflammatory myofibroblastic tumor had excellent prognosis. However, the cases of PPB and PB were both associated with poor clinical outcome, whereas the case of bronchial carcinoid has been doing well on follow-up. PMID:22563158

  9. New concepts in the treatment strategy of neuroendocrine tumors: the role of biotherapy.

    PubMed

    Papaxoinis, George; Syrigos, Kostas; Saif, Muhammad Wasif

    2016-05-01

    Neuroendocrine tumors (NETs) comprise a wide range of neoplasms with diverse biological behaviors, often secreting excessive amounts of endocrine-active substances causing hormone syndromes. They are classified according to the location of the primary site and the level of histological differentiation, which has prognostic as well as therapeutic implications. Biotherapy had traditionally a significant role in the treatment of these tumors, when not amenable to surgery or local treatments. Control of carcinoid syndrome with somatostatin analogs (SSAs) significantly contributed to the improvement of the quality of life. Also, interferon has long been administered, but data were based on small studies. In contrast, PROMID and CLARINET randomized phase III trials provided the first strong evidence of significant improvement in progression-free survival in patients with gastroenteropancreatic (GEP)-NETs with octreotide and lanreotide, respectively, validating somatostatin receptors as important targets. Clinical trials testing the role of these SSAs in other primaries, e.g., lung carcinoids, as well as the efficacy of newer analogs are underway. PMID:27355334

  10. Spectral analysis of tissues from patients with cancer using a portable spectroscopic diagnostic ratiometer unit

    NASA Astrophysics Data System (ADS)

    Sordillo, Laura A.; Pu, Yang; Sordillo, Peter P.; Budansky, Yury; Alfano, R. R.

    2014-05-01

    Spectral profiles of tissues from patients with breast carcinoma, malignant carcinoid and non-small cell lung carcinoma were acquired using native fluorescence spectroscopy. A novel spectroscopic ratiometer device (S3-LED) with selective excitation wavelengths at 280 nm and 335 nm was used to produce the emission spectra of the key biomolecules, tryptophan and NADH, in the tissue samples. In each of the samples, analysis of emission intensity peaks from biomolecules showed increased 340 nm/440 nm and 340 nm/460 nm ratios in the malignant samples compared to their paired normal samples. This most likely represented increased tryptophan to NADH ratios in the malignant tissue samples compared to their paired normal samples. Among the non-small cell lung carcinoma and breast carcinomas, it appeared that tumors of very large size or poor differentiation had an even greater increase in the 340 nm/440 nm and 340 nm/460 nm ratios. In the samples of malignant carcinoid, which is known to be a highly metabolically active tumor, a marked increase in these ratios was also seen.

  11. CT/MRI of neuroendocrine tumours

    PubMed Central

    Reznek, Rodney H

    2006-01-01

    Neuroendocrine tumours (NETs) are often thought to be rare and rather recherché cancers which are of little concern to the general physician, surgeon or radiologist because of their rarity and esoteric nature. In fact, while relatively uncommon, the total group of gastro-entero-pancreatic (GEP) tumours incorporates the spectrum of all types of carcinoids, incuding bronchial carcinoids, and the whole gamut of islet-cell tumours. Some of these may present as functioning tumours, with a plethora of hormonal secretions and concomitant clinical syndromes, and GEPs in general have an incidence around 30 per million population per year. This means that in the whole European Union, for example, there will be in the region of 12000 new patients every year presenting with one or another manifestation of these tumours. Furthermore, the comparatively long survival of many of these patients, compared to more common adenocarcinomas or epithelial tumours, implies that the point prevalence is also not inconsiderable. However, it is undoubtedly true that these tumours can be difficult to identify, especially in their early stages, and it is then that radiological investigation becomes of paramount importance. Having taken into account all these considerations, most investigators would initiate investigation of a suspected or biochemically proven islet-cell tumour with cross-sectional imaging—either CT or MRI. This will clearly identify the larger lesions, allow assessment of the entire abdomen, and provide valuable information on the presence of hepatic metastates. PMID:17114072

  12. Unusual histopathological findings in appendectomy specimens: A retrospective analysis and literature review

    PubMed Central

    Akbulut, Sami; Tas, Mahmut; Sogutcu, Nilgun; Arikanoglu, Zulfu; Basbug, Murat; Ulku, Abdullah; Semur, Heybet; Yagmur, Yusuf

    2011-01-01

    AIM: To document unusual findings in appendectomy specimens. METHODS: The clinicopathological data of 5262 patients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies performed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English language studies published between 2000 and 2010 on unusual findings in appendectomy specimens. RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltrations, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two patients who were diagnosed with tuberculous appendicitis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed. CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appendectomy specimens should be sent for routine histopathological examination. PMID:21528073

  13. Neuroendocrine neoplasms of the small intestine and the appendix - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours).

    PubMed

    Bolanowski, Marek; Bednarczuk, Tomasz; Bobek-Billewicz, Barbara; Handkiewicz-Junak, Daria; Jeziorski, Arkadiusz; Nowakowska-Duława, Ewa; Steinhof-Radwańska, Katarzyna; Zajęcki, Wojciech; Zemczak, Anna; Kos-Kudła, Beata

    2013-01-01

    We present revised Polish guidelines regarding the management of patients harbouring neuroendocrine neoplasms (NENs) of the small intestine and appendix. The small intestine, especially the ileum, is the most common origin of these neoplasms. Most of them are well differentiated with slow growth. Rarely, they are less differentiated, growing fast with a poor prognosis. Since symptoms can be atypical, the diagnosis is often accidental. Typical symptoms of carcinoid syndrome occur in less than 10% of patients. The most useful laboratory marker is chromogranin A; 5-hydroxyindoleacetic acid is helpful in the monitoring of carcinoid syndrome. Ultrasound, computed tomography, magnetic resonance imaging, colonoscopy, video capsule endoscopy, balloon enteroscopy and somatostatin receptors scintigraphy are used in the visualisation. A histological report is crucial for the proper diagnostics and therapy of NENs, and it has been extensively described. The treatment of choice is surgery, either radical or palliative. Somatostatin analogues are crucial in the pharmacological treatment of the hormonally active and non-active small intestine NENs and NENs of the appendix. Radioisotope therapy is possible in patients with a good expression of somatostatin receptors. Chemotherapy is not effective in general. Everolimus therapy can be applied in patients with generalised NENs of the small intestine in progression and where there has been a failure or an inability to use other treatment options. Finally, we make recommendations regarding the monitoring of patients with NENs of the small intestine and appendix.

  14. [Direct experience in the treatment of unusual, primary, and secondary malignant tumors of the stomach].

    PubMed

    Ruggiero, R; De Martino, A; Ferrara, A; Procaccini, F; Procaccini, E

    2001-01-01

    The reduced incidence of gastric cancer, due to a better patients surveillance and more accurate understanding of prophylactic measure, has allowed a detection of early stages as well as cancers with different origin cells. Either the difficulty of differential diagnosis or the various surgical and integrated approaches, make these neoplasm hard to enroll in standard treatment protocols. Our experience consists of 5 clinical cases with four different histology: lymphoma, leiomioma, carcinoid and gastrinoma. A rare case of secondary involvement of the stomach by an adrenal adenocarcinoma is also described. Lymphomas benefit of the surgical therapy only in early stages (IE, IIE), eventually associated to chemio- and radiotherapy, in relationship with local diffusion of the disease; gastric resection is more supported than gastrectomy. Polychemotherapy, with or without radiotherapy, is used for advanced stages (IIIE and IVE), leaving to surgery the role of controlling hemorrhagic or occlusion compliances. GIST have a different therapeutic approach: surgery represents the only choice since chemio- and radiotherapy have no benefits for the biological characteristics of such neoplasm. Surgery is the ideal choice for the carcinoids with some indications for chemio radiotherapy in the palliative surgery or in the relapsing. We emphasize the rarity of the secondary gastric neoplasm coming from the suprarenal glands. We analyze our diagnostic and therapeutic protocols, comparing them with the current literature.

  15. Malignant epithelial tumours in children: incidence and aetiology.

    PubMed

    al-Sheyyab, M; Muir, K R; Cameron, A H; Raafat, F; Pincott, J R; Parkes, S E; Mann, J R

    1993-01-01

    The purpose of this study was to establish the incidence of carcinomas in children, changes in incidence over a 30-year period, and to identify features of possible aetiological significance. A total of 173 cases were identified, but after review of the histopathology, 30 patients were excluded because they were considered to have benign epithelial tumours or malignant tumours of nonepithelial origin. Seven other cases were excluded because pathology material was not available. Overall, in 28% of cases, the diagnoses were changed by pathology review. Thus, 136 children in the West Midlands Region diagnosed 1957-1986 were included, with carcinoid tumours (44) and tumours of skin (22), nasopharynx (14), salivary gland (13), adrenal cortex (13), thyroid (9), large bowel (5), other (16). Excluding carcinoids, the age-standardised incidence rate was 2.4 x 10(6) per year. Male:female ratio was 0.7:1 and 66% were aged > 10 years. Incidence increased from 1.5 to 3.3 x 10(6) per year. Genetic factors predisposing to carcinoma included tyrosinosis, MEN II and III, congenital adrenal hyperplasia and basal cell naevus syndrome. There was a case of Li-Fraumeni syndrome and several other patients had relevant family histories. Probable "environmental" causes included antenatal exposure to stilboestrol or hydroxyprogesterone hexanoate, stilboestrol given for premature menarche, neonatal hepatitis and prior radiotherapy. The aetiology of carcinomas in children is multifactorial, both genetic and environmental factors being important. The incidence is increasing.

  16. Diagnosis and treatment of neuroendocrine lung tumors.

    PubMed

    Sánchez de Cos Escuín, Julio

    2014-09-01

    Pulmonary neuroendocrine tumors (PNT) encompass a broad spectrum of tumors including typical carcinoid (TC) and atypical (AC) tumors, large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC). Although no variety can be considered benign, AC and TC have a much lower metastatic potential, are usually diagnosed in early stages, and most are candidates for surgical treatment. Several chemotherapy (CT) regimens are available in the case of recurrence or in advanced stages, although scientific evidence is insufficient. LCNEC, which is currently classified alongside large-cell carcinomas, have molecular features, biological behavior and CT sensitivity profile closely resembling SCLC. Pathological diagnosis is often difficult, despite the availability of immunohistochemical techniques, and surgical specimens may be necessary. The diagnostic tests used are similar to those used in other lung tumors, with some differences in the optimal tracer in positron emission tomography. The new TNM classification is useful for staging these tumors. Carcinoid syndrome, very rare in PNT, may cause symptoms that are difficult to control and requires special therapy with somatostatin analogs and other drugs. Overall, with the exception of SCLC, new trials are needed to provide a response to the many questions arising with regard to the best treatment in each lineage and each stage. PMID:24685201

  17. A Challenging Case of an Ectopic Cushing Syndrome

    PubMed Central

    Menezes Nunes, Joana; Camões, Isabel; Maciel, João; Cabral Bastos, Pedro; Souto de Moura, Conceição; Bettencourt, Paulo

    2014-01-01

    Bronchopulmonary carcinoids are rare pulmonary neoplasms although they account for most cases of ectopic ACTH syndromes. When feasible, the mainstay treatment is surgical resection of the tumor. We report the case of a 52-year-old woman with signs and symptoms suggestive of hypercortisolism for 12 months, admitted to our department because of community acquired pneumonia. Blood hormone analysis showed increased levels of ACTH and urinary free cortisol and nonsuppressibility to high- and low-dose dexamethasone tests. Pituitary MRI showed no lesion and no central-to-peripheral ACTH gradient was present in bilateral inferior petrosal sinus sampling. CRH stimulation test suggested an ectopic ACTH source. Thoracic CT scan revealed a nodular region measuring 12 mm located in the inferior lingular lobule of the left superior lung with negative uptake by 18-FDG-PET scan and negative SRS. The patient was successfully treated with an atypical lung resection and histology revealed an atypical bronchial carcinoid tumor with positive ACTH immunoreactivity. This was an interesting case because the patient was admitted due to pneumonia that may have been associated with her untreated and chronic hypercortisolism and a challenging case of ectopic ACTH syndrome due to conflicting results on the diagnostic exams. PMID:25431598

  18. Explore medicamentos | Smokefree Español

    Cancer.gov

    Aprenda sobre los medicamentos que lo ayudarán a dejar de fumar, incluso el tratamiento de reemplazo de la nicotina. El uso de estos medicamentos puede duplicar sus probabilidades de dejar de fumar definitivamente.

  19. Neoplasias mieloproliferativas y síndromes mielodisplásicos—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento de las neoplasias mieloproliferativas, así como referencias a estudios clínicos y otros temas relacionados.

  20. Carcinoma de tumor primario desconocido—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del carcinoma de tumor primario desconocido, así como referencias a estudios clínicos y otros temas relacionados.

  1. Is there an overprescription of proton pump inhibitors in oncohematologic patients undergoing ambulatory oncospecific treatment?

    PubMed

    Pujal Herranz, Meritxell

    2016-09-01

    Objetivo: El objetivo de este estudio es analizar la prevalencia de inhibidores de la bomba de protones (IBP) en el paciente oncohematologico de dispensacion ambulatoria y el grado de adecuacion de su indicacion. Método: Estudio observacional descriptivo en pacientes oncohematologicos en tratamiento oncoespecifico de dispensacion ambulatoria. Se elaboro un protocolo dirigido al paciente oncohematologico a partir del protocolo de uso racional de IBP de nuestro hospital. Se cuantificaron los pacientes en tratamiento activo con IBP y se analizo la idoneidad de su indicacion. Resultados: Se incluyeron 111 pacientes (71 oncologicos, 40 hematologicos). El 56% de los pacientes oncologicos y el 63% de los hematologicos estaban en tratamiento activo con IBP. Tras revisar las indicaciones de los pacientes con IBP, el 72% de los oncologicos y el 12% de los hematologicos no presentaron una indicacion que justificara el tratamiento. Conclusiones: Es importante que el farmaceutico detecte las prescripciones inadecuadas de IBP especialmente entre la poblacion oncologica y sugiera una deprescripcion del mismo.

  2. ADHD Medications

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? ADHD Medicines KidsHealth > For Teens > ADHD Medicines Print A ... Medicación para el tratamiento del TDAH (ADHD) Managing ADHD With Medicine Just about everyone has trouble concentrating ...

  3. [Endovascular treatment of critical basilar stenosis with a Solitaire® stent device: a first experience in our centre].

    PubMed

    Mulero, Patricia; Cortijo-García, Elisa; Ruiz-Piñero, Marina; Pérez-Fernández, Santiago; Arenillas-Lara, Juan F; Martínez-Galdámez, Mario

    2014-08-01

    Introduccion. Aunque la arterioesclerosis intracraneal es una causa importante de ictus, la actitud terapeutica no esta claramente establecida. En este sentido, el estudio SAMMPRIS comparo el tratamiento medico intensivo con la angioplastia y colocacion de stent, con resultados favorables al tratamiento farmacologico. Estos resultados podrian, en parte, deberse al dispositivo utilizado (stent Wingspan ®). Caso clinico. Varon de 71 años con una estenosis grave de la arteria basilar, en quien se repetian episodios de focalidad neurologica transitoria a pesar del tratamiento con doble antiagregacion y estatinas. En estas circunstancias se decidio realizar una arteriografia terapeutica con angioplastia y colocacion de un stent Solitaire ® para optimizar resultados y se logro una estenosis residual del 40%. La evolucion fue favorable y los controles posteriores muestran una minima progresion. Conclusion. Segun nuestro conocimiento, este es el primer caso publicado de tratamiento de una estenosis critica de la arteria basilar mediante la colocacion de un stent Solitaire ®.

  4. [Study of tolerance and aceptability of a hyperproteic enteral formula enriched in fiber].

    PubMed

    De Luis, Daniel Antonio; Izaola, Olatz; Castro, A; Martin, M; Torres, B; Lopez Gomez, Jj; Gomez Hoyos, E; Blanco Naveira, Mercedes

    2014-10-18

    Objetivos: Evaluar la tolerancia gastrointestinal y aceptación de la nueva formulación de Isosource Protein ® Fibre® con una nueva mezcla de fibras soluble e insoluble en practica clínica real. Material y métodos: Estudio abierto, no comparativo, no aleatorizado, descriptivo, evaluándose la tolerancia gastrointestinal mediante el registro diario de síntomas gastrointestinales subjetivos por parte del paciente, y objetivos tras la exploración abdominal por parte del investigador. Resultados: Se incluyeron 18 pacientes con una media de edad de 67,32 ±13,8 años y de los cuales un 66,7% eran varones. El peso actual medio de la muestra fue de 68,7±9,8 kg (Rango: 51 - 90 kg) y el IMC 24,0±4,0 kg/ m2 y (Rango: 16,0 - 32,00 kg/m2). El volumen medio final prescrito de Isosource Protein® Fibre® fue de 1580 ± 282,7 ml/día (Rango: 1200 - 2000 ml/día). El 72,22% de los pacientes recibió 1500 ml/día, un 16,67% recibió 1750 ml/día, un 5,56% recibió 2000 ml/día y un 5,56% recibió 2500 ml/día. El análisis de la tolerancia gastrointestinal por parte de los pacientes reveló que en la primera visita del estudio, no refirieron problemas gastrointestinales relevantes, tan solo un paciente indicó la presencia de estreñimiento moderado. Por el contrario, en la última visita del estudio, se observó que dos pacientes refirieron estreñimiento (leve y moderado) y dos pacientes refirieron diarrea (leve y severa). En cuanto a la evaluación de la tolerancia gastrointestinal por parte del investigador y del hábito deposicional, los resultados muestran que en el 100% casos la tolerancia fue normal. Respecto al hábito deposicional se observa significativamente (p=0,035) que el 66,7% de los pacientes no presentaron deposiciones al inicio del estudio, frente al 33,4% en la última visita. En este sentido, se observó un aumento significativo en la media del número de deposiciones diarias en la visita final (0,89 ± 0,90, rango: 0 a 3), respecto a la inicial (0

  5. [Amyotrophyc lateral sclerosis; gastrointestinal complications in home enteral nutrition].

    PubMed

    Ramírez Puerta, R; Yuste Ossorio, E; Narbona Galdó, S; Pérez Izquierdo, N; Peñas Maldonado, L

    2013-11-01

    Objetivos: Analizar las complicaciones relacionadas con el soporte nutricional enteral en los pacientes con esclerosis lateral amiotrófica que forman parte de nuestro programa de ventilación mecánica domiciliaria, haciendo especial hincapié en las gastrointestinales. Método: Estudio retrospectivo de tipo descriptivo de enfermos que se incluyeron en nuestro Programa de Ventilación Mecánica Domiciliaria (PVMD) dirigido por médicos intensivistas, mediante la revisión sistemática de historias clínicas (procedentes de una base de datos de Microsoft Access), durante los años 2004-2011. Resultados: Entre los años 2004-2011 se siguieron 73 pacientes con diagnostico de Esclerosis lateral amiotrófica: 34 de ellos (46,6%) rechazaron el aporte nutricional a través de gastrostomía o de sonda nasogástrica, mientras que 39 (53,4%) aceptaron su colocación. De los 39 pacientes en los que se inició la NED: 20 eran mujeres mujeres (51,3%). La edad media de los pacienes fue de 60,6 + 13,4 años (IC 95% 56,4-64,8). Los diagnósticos al ingreso en el PVMD fueron: ELA, 21 casos (53,8%), y ELA con afectación bulbar, 18 (43,1%). Se alimentaron a través de GEP 34 pacientes (87,2%), con gastrostomía quirúrgica 3 (7,7%) y mediante sonda nasogástrica 3 (7,7%). La gastrostomía percutánea endoscópica se realizó tras la inclusión de los pacientes en el programa, con una media días de 222,7 + 356,6 (IC 95% 110,8-334,7). En pacientes con ELA la media fue de 271,4 + 449,5 días (IC 95% 130,3-412,1), con ELA y afectación bulbar de 126,4 + 131,3 días (IC 95% 90-172,6). El recambio de sonda fue de 7,3 + 4,8 meses (IC 95% 4-10,6). La nutrición enteral tuvo una duración media de 578,6 + 872,9 días (IC 95% 304,7-852,6). Se hallaron complicaciones en 35 pacientes (89,7%), y solamente en 4, no se encontró ninguna (10,3%). Ver tabla 2. El estreñimiento se manifestó, después del inicio de la NE, en 30 pacientes (76,9%); sin embargo, ya existía previamente en 18 de ellos

  6. Hypoglycemic treatment of diabetic patients in the Emergency Department.

    PubMed

    Caballero Requejo, Carmen; Urbieta Sanz, Elena; Trujillano Ruiz, Abel; García-Molina Sáez, Celia; Onteniente Candela, María; Piñera Salmerón, Pascual

    2016-05-01

    Objetivo: Analizar la adecuacion del tratamiento hipoglucemiante prescrito en el Servicio de Urgencias a las recomendaciones de consenso disponibles, asi como evaluar su repercusion clinica. Método: Estudio observacional descriptivo. Se incluyeron pacientes que se encontraban en la sala de observacion del Servicio de Urgencias pendientes de ingreso hospitalario, con diagnostico previo de diabetes mellitus y en tratamiento domiciliario con farmacos hipoglucemiantes. Se evaluo el manejo del tratamiento antidiabetico y su repercusion clinica. Resultados: Se incluyeron 78 pacientes. Al ingreso en el Servicio de Urgencias se modifico el tratamiento en el 91% de los pacientes, y se omitio en el 9%, siendo el tratamiento mas pautado los rescates con insulina rapida (68%). Los tratamientos prescritos se ajustaron en un 16,7% a las recomendaciones de la Sociedad Espanola de Medicina de Urgencias y Emergencias. Tras la intervencion del farmaceutico, la omision descendio al 1,3% y la adecuacion a las recomendaciones aumento al 20,5%. Comparando los pacientes cuyo tratamiento se ajusto a las recomendaciones y los que no, la repercusion clinica fue, respectivamente: media de glucemia a las 24 horas 138,3 } 49,5 mg/dL versus 182,7 } 97,1 mg/dL (p = 0,688); media de rescates con insulina lispro 1 } 1,6 versus 1,5 } 1,8 (p = 0,293); media de unidades de insulina lispro administradas 4,6 } 12,7 UI frente a 6,6 } 11,3 UI (p = 0,155). Conclusiones: Encontramos una baja adecuacion de las prescripciones de antidiabeticos a las recomendaciones de consenso. Estos resultados van en linea con otros estudios, objetivandose un abuso de las pautas de rescate con insulina rapida como unico tratamiento hipoglucemiante.

  7. [Nab-Paclitaxel plus gemcitabine in patients with metastatic pancreatic adenocarcinoma: experience of use].

    PubMed

    Ferris Villanueva, Elena; Martínez Penella, Mónica; Cerezuela Fuentes, Pablo; Guerrero Bautista, Rocío; García Márquez, Andrés; Mira Sirvent, María Del Carmen

    2015-05-01

    Objetivo: Describir los resultados obtenidos en el uso de nab-paclitaxel y gemcitabina en el tratamiento de pacientes con adenocarcinoma de páncreas metastático. Material y métodos: Estudio observacional retrospectivo. Se seleccionaron pacientes en tratamiento con nab-paclitaxel asociado a gemcitabina entre enero 2013 y enero 2014. Se recogieron datos demográficos y clínicos. Resultados: Se incluyeron 15 pacientes (edad media: 59,4 ± 10,3 años). Todos ellos recibieron la combinación de nab-paclitaxel y gemcitabina en primera línea para la enfermedad metastásica. Nueve recibieron tratamiento adyuvante antes de que la enfermedad fuera metastásica, siendo la media de líneas de tratamiento previamente al uso de la combinación de 1,1. La mediana de supervivencia libre de progresión fue de 5,6 meses (IC 95%: 4,44 - 8,03). Sólo dos pacientes suspendieron el tratamiento por toxicidad. Conclusiones: El tratamiento con nab-paclitaxel y gemcitabina en nuestros pacientes ha resultado en una supervivencia libre de progresión similar a la de los ensayos clínicos publicados, presentando además una buena tolerancia.

  8. [Cognitive-behavioural guidance interventions in adolescents with attention deficit hyperactivity disorder].

    PubMed

    Valls-Llagostera, Cristina; Vidal, Raquel; Abad, Alfonso; Corrales, Montse; Richarte, Vanesa; Casas, Miguel; Ramos-Quiroga, Josep A

    2015-02-25

    Introduccion. El trastorno por deficit de atencion/hiperactividad (TDAH) es un trastorno del neurodesarrollo que se puede manifestar a lo largo de la vida. Un 50-70% de los niños diagnosticados presenta el trastorno en la adolescencia. Los jovenes con TDAH tienen elevadas tasas de comorbilidad con otros trastornos psiquiatricos y una elevada afectacion funcional. Objetivo. Revisar la bibliografia de las intervenciones cognitivo-conductuales que se han aplicado al tratamiento del TDAH en la adolescencia. Desarrollo. Se revisan los estudios sobre tratamiento psicologico, clasificando las intervenciones en: tratamientos psicosociales, tratamiento en mindfulness y tratamiento cognitivo-conductual (individual y en formato de grupo). Se revisa el unico estudio publicado sobre terapia cognitivo-conductual para adolescentes con TDAH, asi como un nuevo protocolo de intervencion en formato de grupo diseñado en el Hospital Universitari Vall d'Hebron. Conclusiones. Aunque recientemente se ha incrementado el numero de publicaciones sobre el tratamiento psicologico del TDAH en el adolescente, se requiere un desarrollo mayor de protocolos de intervencion y estudios sobre la eficacia/efectividad de estos.

  9. Observational study of patients with gastroenteropancreatic and bronchial neuroendocrine tumors in Argentina: Results from the large database of a multidisciplinary group clinical multicenter study

    PubMed Central

    O’CONNOR, JUAN MANUEL; MARMISSOLLE, FABIANA; BESTANI, CLAUDIA; PESCE, VERONICA; BELLI, SUSANA; DOMINICHINI, ENZO; MENDEZ, GUILLERMO; PRICE, PAOLA; GIACOMI, NORA; PAIROLA, ALEJANDRO; LORIA, FERNANDO SÁNCHEZ; HUERTAS, EDUARDO; MARTIN, CLAUDIO; PATANE, KARINA; POLERI, CLAUDIA; ROSENBERG, MOISES; CABANNE, ANA; KUJARUK, MIRTA; CAINO, ANALIA; ZAMORA, VICTOR; MARIANI, JAVIER; DIOCA, MARIANO; PARMA, PATRICIA; PODESTA, GUSTAVO; ANDRIANI, OSCAR; GONDOLESI, GABRIEL; ROCA, ENRIQUE

    2014-01-01

    Neuroendocrine tumors (NET) include a spectrum of malignancies arising from neuroendocrine cells throughout the body. The objective of this clinical investigation of retrospectively and prospectively collected data was to describe the prevalence, demographic data, clinical symptoms and methods of diagnosis of NET and the treatment and long-term follow-up of patients with NET. Data were provided by the participating centers and assessed for consistency by internal reviewers. All the cases were centrally evaluated (when necessary) by the pathologists in our group. The tissue samples were reviewed by hematoxylin and eosin and immunohistochemical staining techniques to confirm the diagnosis of NET. In total, 532 cases were documented: 461 gastroenteropancreatic-NET (GEP-NET) and 71 bronchial NET (BNET). All the tumors were immunohistochemically defined according to the World Health Organization (WHO) and European Neuroendocrine Tumor Society criteria. The most common initial symptoms in GEP-NET were abdominal pain, diarrhea, bowel obstruction, flushing, gastrointestinal bleeding and weight loss. The most common tumor types were carcinoid (58.0%), non-functional pancreatic tumor (23.0%), metastatic NET of unknown primary (16.0%) and functional pancreatic tumor (3.0%). Of the BNET, 89.0% were typical and 11.0% atypical carcinoids. Of the patients with GEP-NET, 59.2% had distant metastasis at diagnosis. The locations of the primary tumors in GEP-NET were the small bowel (26.9%), pancreas (25.2%), colon-rectum (12.4%), appendix (7.6%), stomach (6.9%), esophagus (2.8%), duodenum (2.0%) and unknown primary (16.3%). The histological subtypes based on the WHO classification were well-differentiated NET (20.1%), well-differentiated neuroendocrine carcinomas (66.5%) and poorly differentiated neuroendocrine carcinomas (10.3%). Overall, 67.3% of the patients underwent surgery, 41.2% with curative intent and 26.1% for palliative purposes. The 5-year survival rates were 65.1% (95

  10. [Fingolimod: effectiveness and safety in routine clinical practice. An observational, retrospective, multi-centre study in Asturias and Cantabria].

    PubMed

    Oterino, A; Uria, D F; Pena, J; Solar, D; Villafani, J; Oliva-Nacarino, P; Suarez-Moro, R; Quintanilla, V G

    2016-09-01

    Objetivo. Evaluar la efectividad y seguridad del fingolimod en la practica clinica habitual en la region de Asturias y Cantabria (España). Pacientes y metodos. Estudio retrospectivo y multicentrico de pacientes con esclerosis multiple recurrente remitente tratados con fingolimod, segun la ficha tecnica. La efectividad se evaluo en los pacientes con al menos un año de tratamiento. Se calculo la tasa anualizada de brotes (TAB), el porcentaje de pacientes libres de brotes y libres de lesiones captantes de gadolinio, y los que mejoraron/mantuvieron la puntuacion en la escala expandida del estado de discapacidad (EDSS). Se analizo la poblacion total y segun el tratamiento previo: inmunomodulador (interferon beta-1 o acetato de glatiramero) o natalizumab. Resultados. Un total de 138 pacientes iniciaron tratamiento con fingolimod; el 60% recibio previamente inmunomodulador; el 28%, natalizumab; y el 9%, ningun tratamiento. Noventa y nueve pacientes estuvieron al menos un año en tratamiento con fingolimod. Despues de un año de tratamiento, el fingolimod disminuyo la TAB en un 67% (1,26 a 0,42; p < 0,0001), aumento el porcentaje de pacientes libres de brotes de un 24% a un 69% (p < 0,0001), y el porcentaje de pacientes libres de lesiones captantes de gadolinio de un 70% a un 85% (p < 0,0106). El 77% de los pacientes mejoro/mantuvo la puntuacion en la EDSS. Resultados similares se observaron en pacientes tratados previamente con inmunomodulador. La efectividad de los pacientes tratados previamente con natalizumab se mantuvo tras el tratamiento con fingolimod. Conclusiones. La practica clinica habitual en las regiones de Asturias y Cantabria muestra que el fingolimod tiene resultados similares a los observados en los ensayos clinicos, al comparar las variables clinicorradiologicas utilizadas en estos ultimos.

  11. [Occipital nerve stimulation for refractory chronic migraine].

    PubMed

    Bermejo, Pedro E; Torres, Cristina V; Sola, Rafael G

    2015-06-01

    Introduccion. La estimulacion de nervios occipitales (ENO) es un tratamiento preventivo de la migraña cronica refractaria que esta adquiriendo una importancia creciente en los ultimos años. Objetivo. Evaluar el mecanismo de accion, estudios clinicos, tecnica de implantacion y criterios de inclusion de la ENO en el tratamiento preventivo de la migraña. Desarrollo. Se realiza una revision no sistematica de la bibliografia sobre los aspectos anteriormente expuestos en la ENO como tratamiento para la migraña cronica. Esta patologia afecta aproximadamente al 2% de la poblacion y da lugar a una importante disminucion de la calidad de vida e interferencia con las actividades laborales y sociales. La ENO es una terapia emergente y prometedora para el tratamiento de la migraña cronica que ha demostrado una disminucion superior al 50% en el dolor en la mayoria de los estudios abiertos y ensayos clinicos publicados. Aunque el mecanismo de accion es desconocido, parece existir una neuromodulacion de la informacion nociceptiva trigeminal en el nucleo caudal del trigemino explicada mediante la teoria de la puerta de entrada de Melzack y Wall. La ENO es un tratamiento seguro y bien tolerado, y los efectos secundarios son habitualmente locales, como desplazamiento de los electrodos o infecciones de la herida quirurgica, que habitualmente no requieren su retirada. Conclusiones. La ENO es un tratamiento eficaz, bien tolerado y seguro en la prevencion de la migraña cronica, y supone una opcion util para aquellos pacientes con migraña cronica refractaria a los tratamientos medicos convencionales.

  12. [Lapatinib plus transtuzumab for HER-2 positiva metastatic breast cancer: experience of use].

    PubMed

    García-Muñoz, C; Cortijo-Cascajares, S; Cañamares-Orbis, I; Goyache-Goñi, M P; Ferrari-Piquero, J M

    2014-04-01

    Objetivo: Describir los resultados obtenidos con la utilización conjunta de dos inhibidores del receptor HER2 (lapatinib y trastuzumab) en el tratamiento del cáncer de mama metastático HER 2 positivo. Método: Estudio observacional retrospectivo. Se seleccionaron pacientes en tratamiento con trastuzumab y lapatinib entre enero de 2010 y mayo de 2012. Se recogieron datos demográficos y clínicos. Resultados: Se incluyeron 23 pacientes con cáncer de mama metastático (edad media de 59,3 ± 13,3 años). Todos ellos habían recibido una media de 5 líneas de tratamiento previo con al menos una línea de tratamiento con trastuzumab. La mediana de supervivencia libre de progresión con lapatinib + trastuzumab combinado con o sin otra quimioterapia asociada fue de 7 meses (IC 95%: 2,78-11,21) y de 3 meses para las pacientes que sólo recibieron lapatinib y trastuzumab. Siete pacientes tuvieron efectos adversos y en cuatro pacientes se suspendió el tratamiento por toxicidad. Conclusiones: El tratamiento con dos inhibidores del receptor HER2 en nuestras pacientes ha resultado en una supervivencia libre de progresión similar a la de los ensayos clínicos publicados cuando las pacientes recibieron lapatinib + trastuzumab y no se combinó con otra terapia antineoplásica, con buena tolerancia al tratamiento.

  13. [Adequate antimicrobial drug use in a third level pediatric hospital].

    PubMed

    Duarte-Raya, Fidencia; Rodríguez-Lechuga, Manuel; De Anda-Gómez, Manuel Alberto; Granados-Ramírez, Martha Patricia; Vargas-Rodríguez, Alexia Gisselle

    2015-01-01

    Introducción: el uso inadecuado de antimicrobianos contribuye al desarrollo de la resistencia bacteriana, reduce la efectividad de los tratamientos establecidos e incrementa los gastos y la mortalidad por enfermedades infecciosas. El objetivo de este artículo es evaluar si el uso de antimicrobianos en pacientes pediátricos hospitalizados se realiza de forma adecuada. Métodos: estudio epidemiológico observacional, transversal en la UMAE No. 48 de León, Guanajuato. Muestra no probabilística, con un 60 % de tratamientos adecuados esperados, desviación estándar 4. Se utilizó la técnica estadística de análisis de distribución de frecuencias por calificación final de tratamiento administrado: profiláctico, terapéutico, restringido, justificado y adecuado. Se realiza chi cuadrada para comparación de porcentajes. Resultados: se evalúan 283 prescripciones antimicrobianas en 217 pacientes, hombres (53 %) y mujeres (47 %). De los cuales fueron tratamientos adecuados: general 51.2 %, justificado 66 %, terapéutico 53.4 %, restringido 40.8 % y profiláctico 48 %. Comparación de porcentajes con chi cuadrada, asociación estadística significativa de tratamiento adecuado en neonatos (chi cuadrada 8.287; p 0.004) y tratamiento inadecuado en prematuros (chi cuadrada 4.853; p 0.028) con p < 0.05. Los antibióticos más usados fueron: penicilinas 43.7 % y aminoglucósidos 37.1 %. Conclusión: solo la mitad de los tratamientos antimicrobianos se prescriben de forma adecuada.

  14. [Chronic myeloid leukemia in an adult with common variable immunodeficiency].

    PubMed

    O'Farrill-Romanillos, Patricia María; Galindo-Pacheco, Lucy Vania; Amaya-Mejía, Adela Sisy; Campos-Romero, Freya Helena; Mendoza-Reyna, Laura Dafne; Pérez-Rocha, Fernando; Segura-Méndez, Nora Hilda

    2014-01-01

    INTRODUCCIÓN: la inmunodeficiencia común variable es la inmunodeficiencia primaria más sintomática, 70 a 80 % de los pacientes presentan neoplasias. Existen escasos informes de pacientes portadores de leucemia mieloide crónica e inmunodeficiencia común variable. CASO CLÍNICO: mujer de 36 años, quien inició su padecimiento con dolor en hipocondrio izquierdo, pérdida de peso de 8 kg en tres meses y esplenomegalia. Los resultados de la biometría hemática indicaron cuenta leucocitaria de 206 000/mL, 8 % de blastos, cuenta plaquetaria de 530 000/mL y hemoglobina de 8 g/dL. Con la ultrasonografía abdominal se identificó esplenomegalia de 19 ´ 12 cm. El cariotipo mostró el gen BCR/ABL 64.20 % IS y cromosoma Filadelfia 100 %. Se diagnosticó leucemia mieloide crónica. Por infecciones gastrointestinales y respiratorias frecuentes, así como por concentraciones reducidas de IgG, IgM e IgA, la paciente fue valorada por el servicio de alergia e inmunología clínica, donde se diagnosticó inmunodeficiencia común variable.

  15. Léiomyosarcome gastrique simulant une tumeur du hile splénique: à propos d'un cas

    PubMed Central

    Tarchouli, Mohamed; Bounaim, Ahmed; Ratbi, Moulay Brahim; Belhamidi, Mohamed Said; Bensal, Abdelhak; Aitidir, Badr; Boudhas, Adil; Ali, Abdelmounaim Ait; Sair, Khalid

    2015-01-01

    Depuis la découverte de leur phénotype particulier, les tumeurs stromales gastro-intestinales représentent les tumeurs mésenchymateuses les plus fréquentes du tractus digestif et ne sont plus confondues avec les vrais léiomyosarcomes gastriques devenant ainsi exceptionnellement rencontrés dans la pratique médicale. Nous rapportons le cas d'une jeune femme de 32 ans admise pour une masse douloureuse de l'hypochondre gauche et chez qui le bilan radiologique objectivait une volumineuse tumeur occupant le hile splénique. Une résection monobloc emportant la masse, la rate, le grand épiploon et une collerette de la paroi gastrique a été effectuée et l'examen histologique a confirmé le diagnostic d'un léiomyosarcome gastrique. Il est extrêmement important de différencier les autres tumeurs mésenchymateuses du tractus digestif des léiomyosarcomes gastriques dont l'exérèse chirurgicale complète reste, jusqu’à présent, le seul traitement à visée curative. PMID:26526400

  16. Tumeur stromale du mésentère: une cause inhabituelle d'une masse abdominale

    PubMed Central

    Tarchouli, Mohamed; Bounaim, Ahmed; Boudhas, Adil; Ratbi, Moulay Brahim; Ndjota, Bobby Nguele; Ali, Abdelmounaim Ait; Sair, Khalid

    2015-01-01

    Les tumeurs stromales gastro-intestinales (GIST) sont les tumeurs mésenchymateuses les plus fréquentes du tractus digestif. Elles représentent une entité nosologique individualisée depuis la découverte de l'expression quasi-constante de la protéine c-Kit détectée par la coloration immunohistochimique de l'antigène CD117. Des tumeurs avec les mêmes caractéristiques morphologiques et immuno-phénotypiques peuvent rarement apparaître en dehors du tractus gastro-intestinal. Nous rapportons le cas d'une jeune patiente de 34 ans présentant une masse tumorale mésentérique se révélant être de nature stromale sans aucun contact avec la paroi intestinale. Il s'agit d'une localisation très rare des tumeurs stromales à laquelle il faut penser en préopératoire afin d'avoir une conduite thérapeutique adaptée et efficace. PMID:26327998

  17. [Headache and functional symptoms].

    PubMed

    Villate, Sebastián; Arroyo, José; Bessolo, Eduardo; Crespín, Fabiana

    2015-04-16

    Introduccion. Las cefaleas constituyen un motivo de consulta frecuente en los consultorios neurologicos, sus causas puede ser variadas y su diagnostico concreto se empobrece al superponerse con otras patologias dolorosas cronicas. Los sindromes funcionales somaticos se caracterizan por cuadros de dolor cronico que califican en forma negativa la calidad de vida, acompanados de sintomas funcionales sin causa organica. Objetivo. Evaluar la prevalencia de sintomas funcionales en pacientes que consultaron por cefaleas. Pacientes y metodos. Se incorporo a todos los pacientes que consultaron por cefaleas en el consultorio de demanda espontanea de neurologia entre marzo y septiembre de 2014. Se realizo una encuesta semiestructurada para evaluar rasgos de personalidad obsesiva, bruxismo, sintomas gastrointestinales, ansiedad, depresion y trastornos del sueno. Resultados. Durante el periodo de estudio, consultaron por cefalea 125 pacientes. El 68,7% de los pacientes con migrana presento sintomas funcionales, y solo el 32,7% de otras cefaleas (p = 0,0001). Conclusion. Los sintomas funcionales fueron prevalentes en los pacientes con cefalea, principalmente en las migranas.

  18. [Churg-Strauss abdominal manifestation].

    PubMed

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo

    2014-01-01

    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  19. [Enviromental factors related to depressive disorders].

    PubMed

    Hernández-Benítez, Catalina Teresa; García-Rodríguez, Alfonso; Leal-Ugarte, Evelia; Peralta-Leal, Valeria; Durán-González, Jorge

    2014-01-01

    Introducción: debido a su alta prevalencia, la depresión mayor, episodio único (DMEU); la depresión mayor recurrente (DMR); y la distimia son consideradas un problema importante de salud pública. El objetivo de este estudio fue identificar y relacionar los factores ambientales en pacientes con DMEU, DMR y distimia. Métodos: 121 pacientes procedentes del Hospital General de Subzona del Instituto Mexicano del Seguro Social (IMSS) de San Andrés Tuxtla, Veracruz, fueron cuestionados mediante una historia clínica con las variables de riesgo. Resultados: 16 pacientes presentaron DMEU, 72 DMR y 33 distimia. En todos prevaleció el sexo femenino. Los trastornos depresivos se observaron con más frecuencia en personas de más de 40 años, casadas, con un nivel de estudios medio o bajo, provenientes de una familia disfuncional, víctimas de violencia familiar, además de ser hijos intermedios. Las comorbilidades que se presentaron fueron trastornos gastrointestinales, obesidad e hipertensión arterial. Conclusión: los principales factores de riesgo que se identificaron para desarrollar trastornos depresivos fueron: ser mujer, tener más de 40 años de edad y estar casada. Las diferencias obtenidas en este estudio respecto a otros probablemente se deban al tamaño de la muestra, los criterios de selección y el origen de la etnia.

  20. [Anorexia-cachexia frequency and its gastrointestinal symptoms association in paliative patients at the Instituto Nacional de Cancerología, México].

    PubMed

    Pérez Camargo, Dana Aline; Allende Pérez, Silvia R; Meneses García, Abelardo; De Nicola Delfin, Luigina; Copca Mendoza, Erika Thalía; Sánchez López, Miriam S; Flores García, Martha Karen; Verástegui Avilés, Emma

    2014-10-01

    Introducción: La anorexia-caquexia es un síndrome frecuente en pacientes oncológicos, particularmente en etapas avanzadas: la prevalencia global de anorexia-caquexia para-neoplásica oscila entre el 20-40% en los enfermos en la fase diagnóstica, y entre el 70–80% en la fase avanzada de la enfermedad. En los enfermos oncológicos es frecuente la coexistencia de alteraciones digestivas estructurales o funcionales, secundarias al crecimiento tumoral y a los fenómenos sistémicos de carácter metabólico, determinados por la interrelación tumor-huésped específicos de la anorexia-caquexia. Objetivo: El objetivo de este trabajo es conocer la frecuencia de anorexia-caquexia, y su asociación con síntomas gastrointestinales en pacientes en terreno paliativo del Instituto Nacional de Cancerología, Ciudad de México, atendidos en el servicio de Cuidados Paliativos. Material y métodos: Se realizó un estudio transversal analítico. Se incluyeron 100 pacientes con diagnóstico de cáncer avanzado, con un rango de edad de 18 y 80 años, y una puntuación de Karnofsky > 50, así como un ECOG.

  1. Pernicious anemia. From past to present.

    PubMed

    Rodríguez de Santiago, E; Ferre Aracil, C; García García de Paredes, A; Moreira Vicente, V F

    2015-01-01

    Pernicious anemia is currently the most common cause of vitamin B12 deficiency in Western countries. The histological lesion upon which this condition is based is autoimmune chronic atrophic gastritis. The destruction of parietal cells causes a deficiency in intrinsic factor, an essential protein for vitamin B12 absorption in the terminal ileum. Advances in the last two decades have reopened the debate on a disease that seemed to have been forgotten due to its apparent simplicity. The new role of H. pylori, the value of parietal cell antibodies and intrinsic factor antibodies, the true usefulness of serum vitamin B12 levels, the risk of adenocarcinoma and gastric carcinoids and oral vitamin B12 treatment are just some of the current issues analyzed in depth in this review. PMID:25680481

  2. Mixed Adenocarcinoid Tumor Presenting as Acute Appendicitis

    PubMed Central

    Regeti, Kalyani; Jehangir, Waqas; Zafar, Shoaib; Sen, Shuvendu; Sidhom, Ibrahim; Yousif, Abdalla

    2016-01-01

    Mixed adenocarcinoid tumors are not uncommon neoplasms of appendix. The clinical presentation of these tumors is often similar to that of acute appendicitis or may present as asymptomatic. These tumors are found incidentally during histopathological examination of the resected appendix following appendectomy or other abdominal procedures. Mixed adenocarcinoids usually behave as adenocarcinomas with rapid metastasis, so prognosis depends upon how aggressive the tumor behaves. The present study reports a case of a 53-year-old male who presented with abdominal pain and fever for 1 day and underwent successful appendectomy and recovered later. Subsequently, a mixed adenocarcinoma with carcinoid features of the appendix was diagnosed by histopathological examination. Follow-up examination of the patient in 3 months revealed metastasis of carcinoma to the peritoneum with adenocarcinoma features.

  3. Skin manifestations of hormone-secreting tumors.

    PubMed

    Jabbour, Serge A

    2010-01-01

    Endocrine and metabolic diseases, besides affecting other organs, can result in changes in cutaneous function and morphology and can lead to a complex symptomatology. Dermatologists may see some of these skin lesions first, either before the endocrinologist, or even after the internist or specialist has missed the right diagnosis. Because some skin lesions might reflect a life-threatening endocrine or metabolic disorder, identifying the underlying disorder is very important, so that patients can receive corrective rather than symptomatic treatment. In this issue, we will review various hormone-secreting tumors, including pituitary disorders (Cushing's syndrome and acromegaly), hyperthyroidism, glucagonoma, carcinoid syndrome, mastocytosis, and hyperandrogenism. We will focus on clinical manifestations, mainly cutaneous, followed by a brief discussion on how to make the diagnosis of each condition in addition to treatment options. PMID:21054708

  4. Hepatobiliary and gastrointestinal manifestations of acromegaly.

    PubMed

    Ezzat, S

    1992-01-01

    Acromegaly is a unique condition characterized by chronic growth hormone (GH) and insulin-like growth factor-1 (IGF-1) hypersecretion usually due to a pituitary adenoma. Rarely, acromegaly can result from a GH-releasing hormone carcinoid or pancreatic neoplasm which stimulates the normal pituitary to secrete GH. This review describes the interactions between acromegaly and the gastrointestinal system. In contrast to the soft tissue and skeletal changes, clinical organomegaly of the liver, kidney, and spleen is unusual in patients with acromegaly and should warrant further investigations. The prevalence of cholelithiasis is notably increased by the use of the otherwise effective GH-lowering somatostatin analog, octreotide. Patients on long-term therapy with this agent may require anticholelithogenic treatment. The frequency of malignant and premalignant polyps of the colon justify the routine screening for these lesions in newly diagnosed patients with acromegaly. PMID:1611713

  5. Composite Epstein-Barr Virus-Associated B-Cell Lymphoproliferative Disorder and Tubular Adenoma in a Rectal Polyp.

    PubMed

    Lo, Amy A; Gao, Juehua; Rao, M Sambasivia; Yang, Guang-Yu

    2016-02-01

    Composite tumors are formed when there is intermingling between two components of separate tumors seen histologically. Cases demonstrating composite tubular adenoma with other types of tumors in the colon are rare. Composite tubular adenomas with nonlymphoid tumors including carcinoids, microcarcinoids, and small cell undifferentiated carcinoma have been reported in the literature. The occurrence of composite lymphoma and tubular adenoma within the colorectal tract is extremely rare. Only three cases have been reported and include one case of mantle cell lymphoma and two cases of diffuse large B-cell lymphoma arising in composite tubular adenomas. We present the first case of composite Epstein-Barr virus-associated B-cell lymphoproliferative disorder and tubular adenoma in a rectal polyp with a benign endoscopic appearance.

  6. Simultaneous analysis of neuroendocrine tumor markers by HPLC-electrochemical detection.

    PubMed

    Manickum, T

    2009-12-15

    A validated, high pressure liquid chromatographic (HPLC) method for simultaneous quantitation of urinary catecholic acids 4-hydroxy-3-methoxymandelic acid (HMMA) (vanylmandelic acid) (VMA), 4-hydroxy-3-methoxyphenylacetic acid (HVA) and 5-hydroxyindole-3-acetic acid (5-HIAA) was developed. Sample preparation involved liquid-liquid extraction of acidified urine, containing iso-HMMA (IS) as internal standard, with ether, evaporation of the organic extract, followed by reconstitution of the residue in phosphate buffer at pH 3.3. After reversed-phase HPLC at 35 degrees C and separation on a Licrospher 125mmx4mm C(18) column (5microm particle size) with phosphate buffer (pH 3.5)-acetone (950:50, v/v) as eluent, quantitation is achieved by electrochemical detection using coulometric detection at a potential of +350mV. The method was successfully applied to routine diagnosis of neuroblastoma, carcinoid syndrome and pheochromocytoma. PMID:19926540

  7. Notch Signaling in Neuroendocrine Tumors

    PubMed Central

    Crabtree, Judy S.; Singleton, Ciera S.; Miele, Lucio

    2016-01-01

    Carcinoids and neuroendocrine tumors (NETs) are a heterogeneous group of tumors that arise from the neuroendocrine cells of the GI tract, endocrine pancreas, and the respiratory system. NETs remain significantly understudied with respect to molecular mechanisms of pathogenesis, particularly the role of cell fate signaling systems such as Notch. The abundance of literature on the Notch pathway is a testament to its complexity in different cellular environments. Notch receptors can function as oncogenes in some contexts and tumor suppressors in others. The genetic heterogeneity of NETs suggests that to fully understand the roles and the potential therapeutic implications of Notch signaling in NETs, a comprehensive analysis of Notch expression patterns and potential roles across all NET subtypes is required. PMID:27148486

  8. [Endocrine tumors of the testis].

    PubMed

    Loy, V; Linke, J

    2003-07-01

    The most characteristic endocrine tumours of the testis are germ cell tumours and sex cord/gonadal stromal tumours. They include the primary carcinoid, the relation of which to teratomas is still unclear. In general, gonadal stromal tumours are rare, however, endocrine activity occurs in at least 10%-20%. Among gonadal stromal tumours, only Leydig cell tumours and Sertoli cell tumours are of practical importance. Endocrine disorders are mostly related to Leydig cell tumours (gynaecomastia, pubertas praecox). Although less frequent than the other gonadal stromal tumours, they can, in principle, occur. The large cell calcifying Sertoli cell tumour occurs in association with other complex disorders (i.e. Peutz-Jeghers syndrome). Valuable markers are: inhibin, calretinin, cytokeratin, melan-A, CD-99, Ki-67, androgen receptor and p53. As the conventional morphology and immunohistological markers frequently overlap, unclear cases should be referred to specialised centres. PMID:14513279

  9. Neuroendocrine tumours - Medical therapy: Biological.

    PubMed

    Rinke, Anja; Krug, Sebastian

    2016-01-01

    Somatostatin analogues (SSA) are well established antisecretory drugs that have been used as first line treatment for symptomatic control in hormonally active neuroendocrine tumours (NET) for three decades. Both available depot formulations of SSA, long-acting repeatable (LAR) octreotide and lanreotide autogel, seem similarly effective and well tolerated, although comparative trials in NET have not been performed. The importance of SSA as antiproliferative treatment has been increasingly recognized during recent years. Two placebo-controlled trials demonstrated significant prolongation of progression free survival under SSA treatment. However, objective response as assessed by imaging is rare. Interferon-α (IFNα) also has antisecretory and antiproliferative efficacy in NET. Due to the less favourable toxicity profile it mainly has a role as add-on option in the refractory setting, especially in carcinoid syndrome patients. Further studies are needed to evaluate the antiproliferative efficacy of the multiligand SSA pasireotide and the role of pegylated IFNα. PMID:26971845

  10. Mapping the gene for hereditary hyperparathyroidism and prolactinoma (MENI[sub Burin]) to chromosome 11q: Evidence for a founder effect in patients from Newfoundland

    SciTech Connect

    Petty, E.M.; Bale, A.E. ); Green, J.S. ); Marx, S.J. ); Taggart, R.T. ); Farid, N. )

    1994-06-01

    An autosomal dominant syndrome of prolactinomas, carcinoids, and hyperparathyroidism was described in four Newfoundland kindreds in 1980 and in one kindred from the Pacific Northwest in 1983. Because this syndrome shares many features with multiple endocrine neoplasia type 1, the gene for which maps to proximal chromosome 11q, the authors performed linkage studies with chromosome 11 markers in prolactinoma families to determine whether the two genes map to the same location. All proximal chromosome 11q markers gave positive LOD scores, and no recombinants were seen with PYGM (LOD score 15.25, recombination fraction .0). All affected individuals from Newfoundland shared the same PYGM allele, providing evidence for a founder effect. The disease in the Pacific Northwest kindred cosegregated with a different PYGM allele. 32 refs., 2 figs., 3 tabs.

  11. Occult secretion of acth and bilateral adrenalectomy: sometimes the messenger has to be shot.

    PubMed

    Chicharro, Sandra; Lecube, Albert; Mesa, Jordi

    2008-12-01

    Cushing's syndrome due to ectopic adrenocorticotrophic hormone (ACTH) secretion is infrequent, the most frequent cause being bronchial carcinoid; nevertheless, in a considerable proportion of cases (up to 16%), the origin of ACTH secretion is not found. Treatment of Cushing's syndrome due to ectopic ACTH secretion is surgical resection of the tumor. However, surgical excision is not always feasible, either because the tumor has not been located, or because it is unresectable; in these cases the question is when to carry out a bilateral adrenalectomy. We present a case of ACTH-dependent hypercortisolism, in which the ectopic origin of ACTH secretion was established from the results of complementary tests (suppression tests, petrosal sinus sampling, imaging); nevertheless, none of the imaging tests was able to identify the secreting tumor. Consequently, after a reasonable interval, a bilateral adrenalectomy was performed, with good clinical results.

  12. Xeroderma pigmentosum variant associated with multiple cancers.

    PubMed

    Kuwamoto, K; Miyauchi-Hashimoto, H; Isei, T; Horio, T

    1999-01-01

    A 62-year-old Japanese man with xeroderma pigmentosum (XP) variant is reported. The patient had developed at least 6 basal cell carcinomas, a squamous cell carcinoma, and a malignant melanoma on sun-exposed areas, and an atypical carcinoid on the right lung. In vivo phototesting showed a normal response. The minimal erythema dose of ultraviolet B (UVB) was not lowered and no delayed peaking of the erythema reaction was observed. His skin fibroblasts exhibited higher sensitivity to UV irradiation, but a normal level of unscheduled DNA and RNA synthesis. Cell fusions with XP group A, C, D, E, F, and G cells after UV irradiation were all complemented. Previous reports together with this case suggest that older XP variant patients have a high frequency of not only skin cancers, but also internal malignancies. PMID:10404723

  13. Gastrin-releasing peptide, a mammalian analog of bombesin, is present in human neuroendocrine lung tumors.

    PubMed Central

    Bostwick, D. G.; Roth, K. A.; Evans, C. J.; Barchas, J. D.; Bensch, K. G.

    1984-01-01

    Several reports have indicated that the amphibian peptide bombesin is present in oat-cell carcinoma of the human lung. The recent observation that gastrin-releasing peptide (GRP), a 27-amino acid peptide isolated from porcine intestine, may be the mammalian analog of bombesin led the authors to look for this peptide in human pulmonary tumors. Examination of 36 human lung tumors (8 carcinoids, 8 oat-cell carcinomas, and 20 non-oat-cell carcinomas) by immunohistochemistry and radioimmunoassay demonstrated the presence of high, although variable, levels of GRP in neuroendocrine tumors, and not in other histologic types. These findings indicate that bombesin immunoreactivity in human lung tumors should be attributed to GRP or GRP-like molecules and that GRP may be a useful marker of neuroendocrine differentiation. Images Figure 1 PMID:6093543

  14. V3 vasopressin receptor and corticotropic phenotype in pituitary and nonpituitary tumors.

    PubMed

    de Keyzer, Y; René, P; Lenne, F; Auzan, C; Clauser, E; Bertagna, X

    1997-01-01

    Pituitary corticotropic cells express a specific vasopressin receptor, called V1b or V3, through which vasopressin stimulates corticotropin secretion. We recently cloned a cDNA coding for this receptor and showed that it belongs to the G protein-coupled receptor family. V3 mRNA is readily detected by RT-PCR in normal human pituitaries and corticotropic pituitary adenomas but not in PRL or GH-secreting adenomas, thus demonstrating that, like POMC itself and the CRH receptor, V3 is a marker of the corticotropic phenotype. Nuclease protection experiments suggest that V3 is overexpressed in some corticotropic adenomas, and thus may play a role in tumor development by activating the phospholipase C-signalling pathway. In addition analysis of its expression in nonpituitary neuroendocrine tumors showed a striking association with carcinoids of the lung responsible for the ectopic ACTH syndrome.

  15. Social phobia: everyone's disorder?

    PubMed

    Jefferson, J W

    1996-01-01

    Several findings suggest that serotonin dysfunction may play at least a partial role in the etiology of social phobia. The cortisol response to fenfluramine, a serotonin agonist, is enhanced in patients with social phobia. Serotonin may be a common denominator between the blushing commonly seen in social phobics and the cutaneous flushing occurring in patients with carcinoid syndrome, although this is unlikely. Drugs that have demonstrated effectiveness in social phobia include the serotonin selective reuptake inhibitors (SSRIs), clonazepam (a benzodiazepine that potentiates serotonin function and synthesis), monoamine oxidase inhibitors (MAOIs) (which block the oxidative deamination of serotonin), and beta-adrenoceptor blockers (which control the synthesis of melatonin from serotonin). A variety of beta-blockers, some acting centrally and some peripherally, have been effective in the treatment of performance anxiety, a specific form of social phobia. PMID:8647795

  16. 10 rare tumors that warrant a genetics referral.

    PubMed

    Banks, Kimberly C; Moline, Jessica J; Marvin, Monica L; Newlin, Anna C; Vogel, Kristen J

    2013-03-01

    The number of described cancer susceptibility syndromes continues to grow, as does our knowledge on how to manage these syndromes with the aim of early detection and cancer prevention. Oncologists now have greater responsibility to recognize patterns of cancer that warrant referral for a genetics consultation. While some patterns of common cancers are easy to recognize as related to hereditary cancer syndromes, there are a number of rare tumors that are highly associated with cancer syndromes yet are often overlooked given their infrequency. We present a review of ten rare tumors that are strongly associated with hereditary cancer predisposition syndromes: adrenocortical carcinoma, carcinoid tumors, diffuse gastric cancer, fallopian tube/primary peritoneal cancer, leiomyosarcoma, medullary thyroid cancer, paraganglioma/pheochromocytoma, renal cell carcinoma of chromophobe, hybrid oncocytoic, or oncocytoma histology, sebaceous carcinoma, and sex cord tumors with annular tubules. This review will serve as a guide for oncologists to assist in the recognition of rare tumors that warrant referral for a genetic consultation.

  17. Cutaneous manifestations of lung cancer.

    PubMed

    Owen, Cindy England

    2016-06-01

    Skin findings can serve as a clue to internal disease. In this article, cutaneous manifestations of underlying lung malignancy are reviewed. Paraneoplastic dermatoses are rare, but when recognized early, can lead to early diagnosis of an underlying neoplasm. Malignancy-associated dermatoses comprise a broad group of hyperproliferative and inflammatory disorders, disorders caused by tumor production of hormonal or metabolic factors, autoimmune connective tissue diseases, among others. In this review, paraneoplastic syndromes associated with lung malignancy are discussed, including ectopic ACTH syndrome, bronchial carcinoid variant syndrome, secondary hypertrophic osteoarthropathy/digital clubbing, erythema gyratum repens, malignant acanthosis nigricans, sign of Leser-Trélat, tripe palms, hypertrichosis lanuginosa, acrokeratosis paraneoplastica, and dermatomyositis. PMID:27178690

  18. Surgical management of neuroendocrine tumors of the gastrointestinal tract.

    PubMed

    Huang, Lyen C; Poultsides, George A; Norton, Jeffrey A

    2011-08-01

    Neuroendocrine tumors of the pancreas (islet cell tumors) and of the luminal gastrointestinal tract (carcinoids) are a heterogeneous group of epithelial neoplasms that share certain common characteristics. First, they are similar histologically and are difficult to distinguish under light microscopy. Second, they can be associated with hypersecretory syndromes. Third, they are generally slow-growing and have a better prognosis than adenocarcinomas at the same site; however, they do become incurable when they progress to unresectable metastatic disease. Surgery is the only curative treatment and is recommended for most patients for whom cross-sectional imaging suggests that complete resection is possible. This article reviews the surgical management of gastrointestinal neuroendocrine tumors, including the preoperative control of hormonal symptoms, extent of resection required, postoperative outcomes, and differing management strategies as determined by whether the tumor has arisen sporadically or as part of a familial disorder, such as multiple endocrine neoplasia type 1 (MEN1). PMID:21936439

  19. [ACTH's ectopic secretion in a patient with precedents of Cushing's disease].

    PubMed

    Dal Verme, Agustín; Cejas, Carlos; Margan, Mercedes; Siguelboim, Daniel; Canosa, Victoria; Peralta, Christian

    2015-01-01

    A 54-year-old man, with a history of Cushing's disease diagnosed 32 years earlier, presented with edema, asthenia and general malaise. Abnormal laboratory studies depicted hypokalemia and metabolic alkalosis. A CT scan of the chest revealed a 3×3 cm tumor in the anterior mediastinum. The pathology was consistent with a thymic carcinoid. These findings led to a diagnosis of biochemical Cushing's syndrome secondary to ectopic secretion of ACTH. Thus, this patient suffered twice of Cushing's syndrome. The first instance was the consequence of an ACTH--secreting pituitary adenoma and the second of an ectopic secretion of ACTH. To the best of our knowledge this is the first such case reported in the medical literature.

  20. Evolution in the treatment of gastroenteropancreatic-neuroendocrine neoplasms, focus on systemic therapeutic options: a systematic review.

    PubMed

    Pusceddu, Sara; De Braud, Filippo; Festinese, Fabrizio; Bregant, Cristina; Lorenzoni, Alice; Maccauro, Marco; Milione, Massimo; Concas, Laura; Formisano, Barbara; Leuzzi, Livia; Mazzaferro, Vincenzo; Buzzoni, Roberto

    2015-01-01

    Neuroendocrine neoplasms (NENs) are a group of heterogeneous tumors. The present review discusses current therapeutic strategies for the treatment of gastro-entero-pancreatic NEN. Several systemic options are currently available, including medical systemic chemotherapy, biological drugs, somatostatin analogs and peptide receptor radionuclide therapy. The carcinoid syndrome can be adequately controlled with somatostatin analogs; chemotherapy has shown positive outcomes in poor prognosis patients, and peptide receptor radionuclide therapy is a promising treatment based on the use of radioisotopes for advanced disease expressing somatostatin receptors. Targeted therapies, such as multikinase inhibitors and monoclonal antibodies are also recommended or under evaluation for the treatment of advanced NENs, but some critical issues in clinical practice remain unresolved. Depending upon the development of the disease, a multimodal approach is recommended. The treatment strategy for metastatic patients should be planned by a multidisciplinary team in order to define the optimal sequence of treatments.

  1. Recent advances in diagnosis and therapy of neuroendocrine tumors of the gastrointestinal tract.

    PubMed

    Pelley, R J; Bukowski, R M

    1997-01-01

    Neuroendocrine tumors of the gastrointestinal tract are rare tumors that can be classified as APU-Domas (amine precursor uptake and decarboxylation). They can be subdivided into the carcinoid tumors of the gastrointestinal submucosa and the islet cell endocrine tumors of the pancreas. Although the majority of tumors that become clinically apparent are malignant, they are frequently slow growing. Despite this, neuroendocrine tumors may generate disabling hormonal syndromes requiring aggressive treatment to achieve palliation. Recent advances in understanding the pathophysiology of these tumors has led to better radiographic imaging and more accurate localization techniques. Medical therapies with somatostatin analogues, omeprazole, and locoregional tumor ablation have made a positive impact on curative and palliative therapy. This review updates the recent efforts made in the radiographic imaging and therapeutics of the gastrointestinal neuroendocrine tumors.

  2. Mitral valve repair after a right pneumonectomy: a minimally invasive approach.

    PubMed

    Rose, David; Liew, Chee K; Zacharias, Joseph

    2015-10-01

    A 31-year old man was admitted to our unit with severe mitral regurgitation secondary to infective endocarditis on a background of a right pneumonectomy performed 8 years previously for a central carcinoid tumour. A previous right thoracotomy for lung resection is considered a contraindication to a minimal access approach to the mitral valve. Following the right pneumonectomy, a left-to-right displacement of the mediastinum had occurred. We report our experience on performing a mitral valve repair through a right mini-thoracotomy in a patient who had undergone a right pneumonectomy. In this case, three-dimensional computed tomography reconstructions were used to guide our surgical approach. We hope that this case presentation will help further broaden the applicability of a thru-port approach to this rare subgroup of patients.

  3. [Cardiac failure in endocrine diseases].

    PubMed

    Hashizume, K

    1993-05-01

    Several endocrine diseases show the symptoms of cardiac failure. Among them, patients with acromegaly show a specific cardiomyopathy which results in a severe left-sided cardiac failure. Hypoparathyroidism also induces cardiac failure, which is resulted from hypocalcemia and low levels of serum parathyroid hormone. In the cases of hypothyroidism, the patients with myxedemal coma show a severe cardiac failure, which is characterized by disturbance of central nervous system, renal function, and cardiac function. In the patients with thyroid crisis (storm), the cardiac failure comes from the great reduction of cardiac output with dehydration. The reduction of circulation volume, observed in the patients with pheochromocytoma easily induces cardiac failure (shock) just after the removal of adrenal tumor. In patients with malignant carcinoid syndrome, right-sided ventricular failure which may be occurred through the actions of biogenic amines is observed. PMID:8331806

  4. Long Term Proton Pump Inhibitor Use and Gastrointestinal Cancer

    PubMed Central

    Graham, David Y.; Genta, Robert M.

    2010-01-01

    Proton pump inhibitors profoundly affect the stomach and have been associated with carcinoid tumors in female rats. There is now sufficient experience with this class of drugs to allow reasonable estimation of their safety in terms of cancer development. Long term proton pump inhibitor use is associated with an increase in gastric inflammation and development of atrophy among those with active Helicobacter pylori infections. The actual risk is unknown but is clearly low. However, it can be markedly reduced or eliminated by H. pylori eradication leading to the recommendation that patients considered for long term proton pump inhibitor therapy be tested for H. pylori infection and if present, it should be eradicated. Oxyntic cell hyperplasia, glandular dilatations, and fundic gland polyps may develop in H. pylori-uninfected patients, but these changes are believed to be reversible and without significant cancer risk. PMID:19006608

  5. Pernicious anemia. From past to present.

    PubMed

    Rodríguez de Santiago, E; Ferre Aracil, C; García García de Paredes, A; Moreira Vicente, V F

    2015-01-01

    Pernicious anemia is currently the most common cause of vitamin B12 deficiency in Western countries. The histological lesion upon which this condition is based is autoimmune chronic atrophic gastritis. The destruction of parietal cells causes a deficiency in intrinsic factor, an essential protein for vitamin B12 absorption in the terminal ileum. Advances in the last two decades have reopened the debate on a disease that seemed to have been forgotten due to its apparent simplicity. The new role of H. pylori, the value of parietal cell antibodies and intrinsic factor antibodies, the true usefulness of serum vitamin B12 levels, the risk of adenocarcinoma and gastric carcinoids and oral vitamin B12 treatment are just some of the current issues analyzed in depth in this review.

  6. Pictorial essay of radiological features of benign intrathoracic masses.

    PubMed

    Suut, Syahminan; Al-Ani, Zeid; Allen, Carolyn; Rajiah, Prabhakar; Durr-E-Sabih; Al-Harbi, Abdullah; Al-Jahdali, Hamdan; Khan, Ali Nawaz

    2015-01-01

    With increased exposure of patients to routine imaging, incidental benign intrathoracic masses are frequently recognized. Most have classical imaging features, which are pathognomonic for their benignity. The aim of this pictorial review is to educate the reader of radiological features of several types of intrathoracic masses. The masses are categorized based on their location/origin and are grouped into parenchymal, pleural, mediastinal, or bronchial. Thoracic wall masses that invade the thorax such as neurofibromas and lipomas are included as they may mimic intrathoracic masses. All examples are illustrated and include pulmonary hamartoma, pleural fibroma, sarcoidosis, bronchial carcinoid, and bronchoceles together with a variety of mediastinal cysts on plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI). Sometimes a multimodality approach would be needed to confirm the diagnosis in atypical cases. The study would include the incorporation of radionuclide studies and relevant discussion in a multidisciplinary setting. PMID:26664560

  7. [Acute optic neuropathy: differential diagnoses].

    PubMed

    Buompadre, María Celeste

    2013-09-01

    Introduccion. La alteracion funcional del nervio optico se caracteriza por un deficit en la agudeza visual, en la vision cromatica y en el campo visual, defecto pupilar aferente y, en algunos casos, edema del nervio o atrofia y palidez. Objetivo. Describir el espectro de neuropatias opticas agudas, su clinica, diagnostico y tratamiento, con mayor interes en aquellas de presentacion en la edad pediatrica. Desarrollo. La neuritis optica puede ser monofasica, recurrente o el componente de un cuadro desmielinizante polisintomatico. El objetivo del tratamiento es reducir el numero y la gravedad de los ataques y prevenir discapacidad. La infecciosa es secundaria a diferentes microorganismos (bacterias, virus, hongos y protozoos). El tratamiento depende de la etiologia. La isquemica anterior no arteritica o idiopatica es la forma mas frecuente y es secundaria a enfermedad de pequeños vasos (ciliares posteriores). La neuropatia optica hereditaria o de Leber representa una causa importante de afectacion visual cronica y se caracteriza por la afectacion selectiva de las celulas ganglionares de la retina. Hasta el momento, la terapia solo es de apoyo. En el papiledema asociado a hipertension endocraneal, la agudeza visual generalmente se conserva pero existe aumento de la mancha ciega. El tratamiento se basa en disminuir la hipertension y el factor etiologico si existe. Conclusiones. Las neuropatias opticas agudas constituyen un amplio grupo de entidades, de etiologia diversa y con un pronostico visual variable. La presencia de signos del examen neurologico, fondo de ojo y neuroimagenes pueden orientar hacia el diagnostico y tratamiento oportuno.

  8. [Treatment of trigeminal neuralgia: an update and future prospects of percutaneous techniques].

    PubMed

    Bescós, Agustín; Pascual, Vicenç; Escosa-Bage, Marcos; Malaga, Xavier

    2015-08-01

    Introduccion. La neuralgia del trigemino es uno de los sindromes de dolor facial mas graves. La incidencia anual varia entre el 4-13% y altera de forma significativa la calidad de vida de los afectados. Cuando el dolor no puede controlarse con tratamiento farmacologico, existen diferentes opciones quirurgicas. La seleccion de la tecnica esta basada en estudios observacionales y su aplicacion depende de la experiencia de cada centro. Objetivos. Evaluar la efectividad y el nivel de evidencia del tratamiento farmacologico y quirurgico en la neuralgia del trigemino, y analizar el papel actual de las tecnicas percutaneas en el tratamiento de esta patologia. Desarrollo. El tratamiento inicial de la neuralgia del trigemino es el farmacologico y la carbamacepina es el unico farmaco con suficiente nivel de evidencia. Las tecnicas quirurgicas percutaneas son efectivas y de facil aplicacion, pero la tendencia a la recidiva conduce a la preferencia por la microdescompresion vascular. Sin embargo, no hay estudios comparativos que determinen la superioridad de alguna tecnica con buen nivel de evidencia. Se han revisado las tres tecnicas percutaneas mas utilizadas, la compresion con balon, la rizotomia con glicerol y la termocoagulacion por radiofrecuencia. Esta ultima es la que ha presentado mayor desarrollo en los ultimos años, con la aparicion de tecnicas neurofisiologicas que pueden optimizar los resultados. Conclusiones. La seleccion de una tecnica quirurgica en la neuralgia del trigemino no esta bien apoyada por ensayos clinicos aleatorizados. Los nuevos procedimientos en la aplicacion de la radiofrecuencia pueden mejorar las perspectivas del tratamiento de esta patologia.

  9. [Lacosamide as an alternative in the treatment of post-surgery neuropathic pain in an allergic patient].

    PubMed

    Monge-Márquez, María Estefanía; Márquez-Rivas, Javier; Mayorga-Buiza, María José; Rivero-Garvía, Mónica

    2013-10-01

    Introduccion. El dolor neuropatico es una entidad que no se conoce bien. Afecta a un porcentaje significativo de la poblacion. Su principal problema radica en que puede llegar a ser una patologia bastante invalidante. El tratamiento principal se basa fundamentalmente en dos farmacos: gabapentina y pregabalina. Otros farmacos, como los antidepresivos, los opioides o los antagonistas de receptores de N-metil D-aspartato tambien pueden utilizarse en combinacion con los farmacos principales. A pesar de esto, el tratamiento es poco satisfactorio. Ademas, debe considerarse que pueden existir pacientes que presenten alergia a los dos farmacos principales. Caso clinico. Mujer de 36 años, afecta de dolor neuropatico secundario a una cirugia de neurinoma del plexo braquial, cuyo tratamiento con gabapentina o pregabalina no era posible por tener antecedentes personales de alergia. Sin embargo, el tratamiento con otro farmaco (lacosamida) resulto muy efectivo, al presentar muy buena respuesta. Conclusion. La lacosamida es un farmaco antiepileptico de tercera generacion, eficaz, seguro y con pocos efectos secundarios. Se ha considerado una buena opcion terapeutica para el tratamiento del dolor neuropatico en pacientes alergicos a la pregabalina.

  10. [Programme review of somatropin deficit in pediatrics at the Hospital Universitario Virgen del Rocío].

    PubMed

    Lavaredas, A; de la Puerta, R; Álvarez del Vayo, C

    2013-01-01

    Objetivo: Elaborar una revisión del programa de déficit de somatropina aplicado en pediatría en el Hospital Universitario Virgen del Rocío, utilizando dos grupos de pacientes, los diagnosticados con déficit de esta hormona y los nacidos pequeños para edad gestacional, con la intención de evaluar su efectividad en el primer año de tratamiento. Método: Realización de un estudio retrospectivo de la cohorte de pacientes en tratamiento con la hormona del crecimiento bajo los diagnósticos mencionados, con metodología observacional y transversal, a los cuales se aplicó un análisis estadístico con el programa Statistical Package for Social Sciences®. Resultados: Tras inicio del tratamiento la velocidad de crecimiento y la talla aumentaron y la edad ósea se aproximó a la edad cronológica. En los dos grupos tratados, en el primer año de tratamiento fueron los pacientes del sexo femenino con edad comprendida entre los 0 a 12 años con déficit de la hormona del crecimiento que respondieron mejor a la terapéutica establecida. Conclusiones: Pudimos observar que el tratamiento instituido se presentó altamente efectivo en ambos grupos de pacientes, permitiendo obtener un aumento favorable de estatura.

  11. [Treatment of autism spectrum disorders: union between understanding and evidence-based practice].

    PubMed

    Martos-Pérez, Juan; Llorente-Comí, María

    2013-09-01

    Introduccion. De manera sintetica se da cuenta de las caracteristicas heterogeneas de funcionamiento de las personas con trastornos del espectro autista (TEA) y como dichas caracteristicas tambien pueden estar en la base de la variabilidad en la respuesta al tratamiento. Se recalca la necesidad de combinar, en el tratamiento, la practica basada en la evidencia y una comprension profunda de los TEA. Desarrollo. Se explican algunos de los principios esenciales que deben guiar el tratamiento desde la optica de indicadores de calidad que han de contener los programas de intervencion. Se incide en las caracteristicas y contenidos que forman parte de los programas que se llevan a cabo en el ambito de la intervencion temprana, explicando brevemente algunos de esos programas, y posteriormente se caracteriza la intervencion, con el uso de tecnicas y estrategias, que habitualmente se realiza en niños y adolescentes de alto nivel de funcionamiento. Conclusion. La investigacion y conocimiento acumulados y la cada vez mayor evidencia experimental configuran las caracteristicas que deben adoptar los programas de intervencion y tratamiento usados en personas con TEA. Dicho tratamiento debe comenzar de manera temprana, lo antes posible y extenderse a lo largo del ciclo vital.

  12. [Aetiology and treatment of epilepsy in a series of 1,557 patients].

    PubMed

    Torres-Ferrús, Marta; Toledo, Manuel; González-Cuevas, Montserrat; Seró-Ballesteros, Laia; Santamarina, Esteban; Raspall-Chaure, Miquel; Sueiras-Gil, María; Cambrodí-Masip, Roser; Sarria, Silvana; Álvarez-Sabín, José; Salas-Puig, Javier

    2013-10-01

    Introduccion. La etiologia de la epilepsia es un determinante importante del tratamiento y el pronostico. Los avances diagnosticos y terapeuticos hacen pensar que la distribucion causal, el tratamiento y el pronostico de la poblacion con epilepsia se hayan podido ver modificados. Objetivo. Describir la distribucion sindromica, etiologica y el tratamiento farmacologico en los pacientes con epilepsia. Pacientes y metodos. Estudio descriptivo transversal de pacientes con epilepsia atendidos de manera consecutiva en la consulta de nuestra unidad de epilepsia. Se recogieron datos demograficos, de sindrome, etiologia y tratamiento farmacologico en el momento de la inclusion. Se analizaron los datos de modo conjunto y por grupos de edad. Resultados. Se incluyeron 1.557 pacientes, el 54% varones. El 73% de la muestra tenia una epilepsia focal, que era secundaria a una lesion estructural en el 56%. Las epilepsias generalizadas representaron el 20%. El 5% fue inclasificable. Por edad, la etiologia vascular predominaba en practicamente todos los grupos y su prevalencia aumentaba en relacion con la edad. Los farmacos antiepilepticos mas utilizados fueron acido valproico (29%), levetiracetam (27%) y carbamacepina (20%). El 70% de las epilepsias generalizadas y el 57% de las focales seguian tratamiento en monoterapia. Conclusiones. La prevalencia por grupos de edad fue similar a la descrita en paises desarrollados aunque se observo una menor prevalencia de epilepsias criptogenicas. Mas del 60% de los pacientes seguia monoterapia y el acido valproico fue el mas utilizado.

  13. Weight and body composition variations in overweight women along outpatient nutritional treatment.

    PubMed

    Gonçalves Micali, Flávia; Cremonezi Japur, Camila; Rodrigues de Oliveira Penaforte, Fernanda; Diez-Garcia, Rosa Wanda

    2014-03-01

    Introducción: Para evaluar el tratamiento de la obesidad es necesario entender el curso de los cambios del peso para mejorar las estrategias de intervención. Objetivo: Evaluar el peso y las medidas corporales de mujeres con exceso de peso durante un tratamiento nutricional. Métodos: Fueron evaluadas 163 mujeres, con medición del peso, de las circunferencias (cintura y cadera) y de la composición corporal (masa magra y grasa corporal) en tres fases del tratamiento. Resultados y discusión: El porcentaje de la pérdida de peso fue mayor en la primera que en la segunda fase del tratamiento (-6,8 ± 4,8% vs -4,0 ± 2,7%, p < 0,0001). En las dos primeras fases hubo disminución de las circunferencias y de la masa corporal magra entre las mujeres que perdieron peso. La reducción de la grasa corporal (-2,6%) se produjo sólo en la primera fase. Conclusión: La reducción del peso y de las medidas corporales ocurren principalmente en la primera fase del tratamiento, alertando para la necesidad de una revisión de las estrategias de intervención.

  14. [Not Available].

    PubMed

    Fort Casamartina, Eduard; Arribas Hortiguela, Lorena; Bleda Pérez, Carmen; Muñoz Sánchez, Carme; Peiro Martínez, Imma; Perayre Badía, María; Clopés Estela, Ana

    2016-06-03

    Durante la última década, el conocimiento de nuevos mecanismos implicados en el desarrollo del cáncer ha permitido el diseño de nuevos fármacos para su tratamiento y la mayor parte de ellos son fármacos que se administran por vía oral. Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales (de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados). Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional.

  15. [Not Available].

    PubMed

    Fort Casamartina, Eduard; Arribas Hortiguela, Lorena; Bleda Pérez, Carmen; Muñoz Sánchez, Carme; Peiro Martínez, Imma; Perayre Badía, María; Clopés Estela, Ana

    2016-01-01

    Durante la última década, el conocimiento de nuevos mecanismos implicados en el desarrollo del cáncer ha permitido el diseño de nuevos fármacos para su tratamiento y la mayor parte de ellos son fármacos que se administran por vía oral. Uno de los principales problemas de los pacientes oncohematológicos es la desnutrición, que suele tener causas multifactoriales (de la propia enfermedad, de los pacientes y de los diferentes tratamientos administrados). Para minimizar el impacto de la desnutrición es necesaria una intervención nutricional, ya sea adaptando la dieta o mediante la instauración de soporte nutricional artificial, en función de la gravedad de cada caso. En cualquier paciente que esté recibiendo un tratamiento oncológico hay que evaluar las posibles interacciones que pueden existir con el soporte nutricional instaurado, ya sea dieta oral, suplementación oral o nutrición enteral. Estas interacciones pueden disminuir la eficacia, aumentar la toxicidad de los tratamientos o producir déficits nutricionales. Se detallan las principales interacciones que se pueden producir, las interacciones entre los tratamientos oncológicos y el soporte nutricional. PMID:27269219

  16. Hidden Treasures in “Ancient” Microarrays: Gene-Expression Portrays Biology and Potential Resistance Pathways of Major Lung Cancer Subtypes and Normal Tissue

    PubMed Central

    Kerkentzes, Konstantinos; Lagani, Vincenzo; Tsamardinos, Ioannis; Vyberg, Mogens; Røe, Oluf Dimitri

    2014-01-01

    Objective: Novel statistical methods and increasingly more accurate gene annotations can transform “old” biological data into a renewed source of knowledge with potential clinical relevance. Here, we provide an in silico proof-of-concept by extracting novel information from a high-quality mRNA expression dataset, originally published in 2001, using state-of-the-art bioinformatics approaches. Methods: The dataset consists of histologically defined cases of lung adenocarcinoma (AD), squamous (SQ) cell carcinoma, small-cell lung cancer, carcinoid, metastasis (breast and colon AD), and normal lung specimens (203 samples in total). A battery of statistical tests was used for identifying differential gene expressions, diagnostic and prognostic genes, enriched gene ontologies, and signaling pathways. Results: Our results showed that gene expressions faithfully recapitulate immunohistochemical subtype markers, as chromogranin A in carcinoids, cytokeratin 5, p63 in SQ, and TTF1 in non-squamous types. Moreover, biological information with putative clinical relevance was revealed as potentially novel diagnostic genes for each subtype with specificity 93–100% (AUC = 0.93–1.00). Cancer subtypes were characterized by (a) differential expression of treatment target genes as TYMS, HER2, and HER3 and (b) overrepresentation of treatment-related pathways like cell cycle, DNA repair, and ERBB pathways. The vascular smooth muscle contraction, leukocyte trans-endothelial migration, and actin cytoskeleton pathways were overexpressed in normal tissue. Conclusion: Reanalysis of this public dataset displayed the known biological features of lung cancer subtypes and revealed novel pathways of potentially clinical importance. The findings also support our hypothesis that even old omics data of high quality can be a source of significant biological information when appropriate bioinformatics methods are used. PMID:25325012

  17. Apparent homozygote for the prolactinoma variant of MEN-1

    SciTech Connect

    Green, J.S.; Fitzpatrick, J.; Petty, E.M. |

    1994-09-01

    Four probably related families from the south coast of Newfoundland with the prolactinoma variant of MEN-1 (MEN-1 BURIN) have been described. Linkage studies have recently demonstrated that the MEN-1 BURIN gene maps to the same 11q13 location as the gene for typical MEN-1 (Z=13.65, {theta}=0.0 for linkage with PYGM). These linkage studies have also identified a probable homozygote for MEN-1 BURIN who at age 42 is asymptomatic and has normal screening values for ionized calcium, PTH, prolacting and gastrin. Her parents, from 2 different MEN-1 BURIN families, were both affected but are now deceased; (each had hyperparathyroidism (HPTH) and prolactinoma (PRL), and the mother also had a malignant bronchial carcinoid tumor (CARC)). The patient`s only sibling (with HPTH, PRL, CARC) died at age 32 of a malignant carcinoid tumour of the thymus, and this sibling`s son, at age 26, has HPTH, PRL and pancreatic islet cell tumour. Haplotypes for the parents were reconstructed based on known haplotypes of children, grandchildren and multiple affected and unaffected siblings of each. The probable homozygote has inherited the alleles from each parent that are associated with the disease (for markers D11S2Y88, PYGM, D11S971 and D11S146). Two homozygotes for typical MEN-1 have previously been described with no phenotypic differences from the heterozygous family members. It will be of interest to study these patients further when the MEN-1 gene(s) is cloned and specific mutations can be identified.

  18. [Therapeutic advances of nuclear medicine in oncology].

    PubMed

    Valdés Olmos, R A; Hoefnagel, C A; Bais, E; Boot, H; Taal, B; de Kraker, J; Vote, P A

    2001-12-01

    With the development of new radiopharmaceuticals there is a tendency to apply nuclear medicine therapy for malignancies of higher incidence (lymphoma, prostate) than the ones which have been treated for many years (thyroid cancer, neuroendocrine tumours). One of the most important areas of current development in radionuclide cancer therapy is the monotherapeutic use of new or already available radiopharmaceuticals in preclinical or phase I studies and to a lesser degree in phase II trials. In this context, the radioimmunotherapy is showing important advances in the treatment of medullary thyroid carcinoma, malignant lymphomas en brain tumours with potential extension to neuroblastoma therapy. The development of DOTA as a chelating agent has lead to the use of Y-90-DOTATOC in the treatment of neuroendocrine tumours, particularly carcinoid tumours, and non-I131I-avid thyroid carcinomas. In an effort to improve tumour targeting together with simultaneous reduction of physiological organ uptake, 131I-MIBG is being used in combination with interferon a and pre-targeting with unlabelled MIBG in the treatment of carcinoid tumours. New routes of administration of radiopharmaceuticals (intratumoral, intra-arterial) have enhanced the treatment of malignancies of liver, pancreas and brain as well as the potential use of radioimmunotherapy by intravesical administration for bladder carcinoma. Another significant tendency in radionuclide therapy is its evolution from monotherapy towards a combined application with other anticancer modalities. Some recent examples of combined therapy with demonstrated anti-tumour effect are found in neuroblastoma (131I-MIBG and chemotherapy), bone metastases of prostatic carcinoma (addition of 89Sr to chemotherapy schedules), brain malignancies (adjuvant use of radioimmnunotherapy in relation to surgery and external radiotherapy) and lymphoma (radioimmunotherapy combined with chemotherapy or immunotherapy). Reinforcing this trend in phase II and

  19. Unraveling tumor grading and genomic landscape in lung neuroendocrine tumors.

    PubMed

    Pelosi, Giuseppe; Papotti, Mauro; Rindi, Guido; Scarpa, Aldo

    2014-06-01

    Currently, grading in lung neuroendocrine tumors (NETs) is inherently defined by the histological classification based on cell features, mitosis count, and necrosis, for which typical carcinoids (TC) are low-grade malignant tumors with long life expectation, atypical carcinoids (AC) intermediate-grade malignant tumors with more aggressive clinical behavior, and large cell NE carcinomas (LCNEC) and small cell lung carcinomas (SCLC) high-grade malignant tumors with dismal prognosis. While Ki-67 antigen labeling index, highlighting the proportion of proliferating tumor cells, has largely been used in digestive NETs for assessing prognosis and assisting therapy decisions, the same marker does not play an established role in the diagnosis, grading, and prognosis of lung NETs. Next generation sequencing techniques (NGS), thanks to their astonishing ability to process in a shorter timeframe up to billions of DNA strands, are radically revolutionizing our approach to diagnosis and therapy of tumors, including lung cancer. When applied to single genes, panels of genes, exome, or the whole genome by using either frozen or paraffin tissues, NGS techniques increase our understanding of cancer, thus realizing the bases of precision medicine. Data are emerging that TC and AC are mainly altered in chromatin remodeling genes, whereas LCNEC and SCLC are also mutated in cell cycle checkpoint and cell differentiation regulators. A common denominator to all lung NETs is a deregulation of cell proliferation, which represents a biological rationale for morphologic (mitoses and necrosis) and molecular (Ki-67 antigen) parameters to successfully serve as predictors of tumor behavior (i.e., identification of pathological entities with clinical correlation). It is envisaged that a novel grading system in lung NETs based on the combined assessment of mitoses, necrosis, and Ki-67 LI may offer a better stratification of prognostic classes, realizing a bridge between molecular alterations

  20. Vascular endothelial growth factor and nitric oxide synthase expression in human lung cancer and the relation to p53.

    PubMed Central

    Ambs, S.; Bennett, W. P.; Merriam, W. G.; Ogunfusika, M. O.; Oser, S. M.; Khan, M. A.; Jones, R. T.; Harris, C. C.

    1998-01-01

    Vascular endothelial growth factor (VEGF) expression and mutations of cancer-related genes increase with cancer progression. This correlation suggests the hypothesis that oncogenes and tumour suppressors regulate VEGF, and a significant correlation between p53 alteration and increased VEGF expression in human lung cancer was reported recently. To further examine this hypothesis, we analysed VEGF protein expression and mutations in p53 and K-ras in 27 non-small-cell lung cancers (NSCLC): 16 squamous cell, six adenocarcinomas, one large cell, two carcinoids and two undifferentiated tumours. VEGF was expressed in 50% of the squamous cell carcinomas (SCC) and carcinoids but none of the others. p53 mutations occurred in 14 tumours (52%), and K-ras mutations were found in two adenocarcinomas and one SCC; there was no correlation between the mutations and VEGF expression. As nitric oxide also regulates angiogenesis, we examined NOS expression in NSCLC. The Ca2+-dependent NOS activity, which indicates NOS1 and NOS3 expression, was significantly reduced in lung carcinomas compared with adjacent non-tumour tissue (P < 0.004). Although the Ca2+-independent NOS activity, which indicates NOS2 expression, was low or undetectable in non-tumour tissues and most carcinomas, significant activity occurred in three SCC. In summary, our data do not show a direct regulation of VEGF by p53 in NSCLC. Finally, we did not find the up-regulation of NOS isoforms during NSCLC progression that has been suggested for gynaecological and breast cancers. Images Figure 1 Figure 4 Figure 5 PMID:9683299

  1. Down-Regulation of miR-129-5p and the let-7 Family in Neuroendocrine Tumors and Metastases Leads to Up-Regulation of Their Targets Egr1, G3bp1, Hmga2 and Bach1

    PubMed Central

    Døssing, Kristina B. V.; Binderup, Tina; Kaczkowski, Bogumil; Jacobsen, Anders; Rossing, Maria; Winther, Ole; Federspiel, Birgitte; Knigge, Ulrich; Kjær, Andreas; Friis-Hansen, Lennart

    2014-01-01

    Expression of miRNAs in Neuroendocrine Neoplasms (NEN) is poorly characterized. We therefore wanted to examine the miRNA expression in Neuroendocrine Tumors (NETs), and identify their targets and importance in NET carcinogenesis. miRNA expression in six NEN primary tumors, six NEN metastases and four normal intestinal tissues was characterized using miRNA arrays, and validated by in-situ hybridization and qPCR. Among the down-regulated miRNAs miR-129-5p and the let-7f/let-7 family, were selected for further characterization. Transfection of miR-129-5p inhibited growth of a pulmonary and an intestinal carcinoid cell line. Analysis of mRNA expression changes identified EGR1 and G3BP1 as miR-129-5p targets. They were validated by luciferase assay and western blotting, and found robustly expressed in NETs by immunohistochemistry. Knockdown of EGR1 and G3BP1 mimicked the growth inhibition induced by miR-129-5p. let-7 overexpression inhibited growth of carcinoid cell lines, and let-7 inhibition increased protein content of the transcription factor BACH1 and its targets MMP1 and HMGA2, all known to promote bone metastases. Immunohistochemistry analysis revealed that let-7 targets are highly expressed in NETs and metastases. We found down-regulation of miR-129-5p and the let-7 family, and identified new neuroendocrine specific targets for these miRNAs, which contributes to the growth and metastatic potential of these tumors. PMID:25546138

  2. A phase II study of axitinib in advanced neuroendocrine tumors

    PubMed Central

    Strosberg, J R; Cives, M; Hwang, J; Weber, T; Nickerson, M; Atreya, C E; Venook, A; Kelley, R K; Valone, T; Morse, B; Coppola, D; Bergsland, E K

    2016-01-01

    Neuroendocrine tumors (NETs) are highly vascular neoplasms overexpressing vascular endothelial growth factor (VEGF) as well as VEGF receptors (VEGFR). Axitinib is a potent, selective inhibitor of VEGFR-1, -2 and -3, currently approved for the treatment of advanced renal cell carcinoma. We performed an open-label, two-stage design, phase II trial of axitinib 5 mg twice daily in patients with progressive unresectable/metastatic low-to-intermediate grade carcinoid tumors. The primary end points were progression-free survival (PFS) and 12-month PFS rate. The secondary end points included time to treatment failure (TTF), overall survival (OS), overall radiographic response rate (ORR), biochemical response rate and safety. A total of 30 patients were enrolled and assessable for toxicity; 22 patients were assessable for response. After a median follow-up of 29 months, we observed a median PFS of 26.7 months (95% CI, 11.4–35.1), with a 12-month PFS rate of 74.5% (±10.2). The median OS was 45.3 months (95% CI, 24.4–45.3), and the median TTF was 9.6 months (95% CI, 5.5–12). The best radiographic response was partial response (PR) in 1/30 (3%) and stable disease (SD) in 21/30 patients (70%); 8/30 patients (27%) were unevaluable due to early withdrawal due to toxicity. Hypertension was the most common toxicity that developed in 27 patients (90%). Grade 3/4 hypertension was recorded in 19 patients (63%), leading to treatment discontinuation in six patients (20%). Although axitinib appears to have an inhibitory effect on tumor growth in patients with advanced, progressive carcinoid tumors, the high rate of grade 3/4 hypertension may represent a potential impediment to its use in unselected patients. PMID:27080472

  3. Next-Generation Sequencing of Pulmonary Large Cell Neuroendocrine Carcinoma Reveals Small Cell Carcinoma–like and Non–Small Cell Carcinoma–like Subsets

    PubMed Central

    Rekhtman, Natasha; Pietanza, Maria C.; Hellmann, Matthew D.; Naidoo, Jarushka; Arora, Arshi; Won, Helen; Halpenny, Darragh F.; Wang, Hangjun; Tian, Shaozhou K.; Litvak, Anya M.; Paik, Paul K.; Drilon, Alexander E.; Socci, Nicholas; Poirier, John T.; Shen, Ronglai; Berger, Michael F.; Moreira, Andre L.; Travis, William D.; Rudin, Charles M.; Ladanyi, Marc

    2016-01-01

    Purpose Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a highly aggressive neoplasm, whose biologic relationship to small cell lung carcinoma (SCLC) versus non-SCLC (NSCLC) remains unclear, contributing to uncertainty regarding optimal clinical management. To clarify these relationships, we analyzed genomic alterations in LCNEC compared with other major lung carcinoma types. Experimental Design LCNEC (n = 45) tumor/normal pairs underwent targeted next-generation sequencing of 241 cancer genes by Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT) platform and comprehensive histologic, immunohistochemical, and clinical analysis. Genomic data were compared with MSK-IMPACT analysis of other lung carcinoma histologies (n = 242). Results Commonly altered genes in LCNEC included TP53 (78%), RB1 (38%), STK11 (33%), KEAP1 (31%), and KRAS (22%). Genomic profiles segregated LCNEC into 2 major and 1 minor subsets: SCLC-like (n = 18), characterized by TP53+RB1 co-mutation/loss and other SCLC-type alterations, including MYCL amplification; NSCLC-like (n = 25), characterized by the lack of coaltered TP53+RB1 and nearly universal occurrence of NSCLC-type mutations (STK11, KRAS, and KEAP1); and carcinoid-like (n = 2), characterized by MEN1 mutations and low mutation burden. SCLC-like and NSCLC-like subsets revealed several clinicopathologic differences, including higher proliferative activity in SCLC-like tumors (P < 0.0001) and exclusive adenocarcinoma-type differentiation marker expression in NSCLC-like tumors (P = 0.005). While exhibiting predominant similarity with lung adenocarcinoma, NSCLC-like LCNEC harbored several distinctive genomic alterations, including more frequent mutations in NOTCH family genes (28%), implicated as key regulators of neuroendocrine differentiation. Conclusions LCNEC is a biologically heterogeneous group of tumors, comprising distinct subsets with genomic signatures of SCLC, NSCLC (predominantly

  4. Criptococosis cutánea primaria en paciente inmunocompetente.

    PubMed

    Osorio, Igor Vázquez; García-Rodiño, Sara; Rodríguez-Rodríguez, Marta; Labandeira, Javier; Suárez-Peñaranda, José Manuel; Sánchez-Aguilar, MDolores; Vázquez-Veiga, Hugo

    2016-01-01

    La criptococosis cutánea es una micosis propia de pacientes inmunodeprimidos, sobre todo aquellos con infección por el virusde la inmunodeficiencia humana (VIH). Sin embargo, existen casos infrecuentes de criptococosis cutánea en pacientes inmunocompetentes, que suelen simular otras dermatosis, lo que retrasa su diagnóstico y tratamiento. Presentamos el caso de un varón pluripatológico de 79 años, con úlceras dolorosas en dorso de mano derecha que no respondían a tratamientos tópicos. A través del estudio histopatológico y micológico se alcanzó el diagnóstico de criptococosis cutánea primaria, lográndose la remisión de las lesiones tras 6 meses de tratamiento con fluconazol. PMID:27617525

  5. Criptococosis cutánea primaria en paciente inmunocompetente.

    PubMed

    Vázquez-Osorio, Igor; García-Rodiño, Sara; Rodríguez-Rodríguez, Marta; Labandeira, Javier; Suárez-Peñaranda, José Manuel; Sánchez-Aguilar, MDolores; Vázquez-Veiga, Hugo

    2016-05-15

    La criptococosis cutánea es una micosis propia de pacientes inmunodeprimidos, sobre todo aquellos con infección por el virusde la inmunodeficiencia humana (VIH). Sin embargo, existen casos infrecuentes de criptococosis cutánea en pacientes inmunocompetentes, que suelen simular otras dermatosis, lo que retrasa su diagnóstico y tratamiento. Presentamos el caso de un varón pluripatológico de 79 años, con úlceras dolorosas en dorso de mano derecha que no respondían a tratamientos tópicos. A través del estudio histopatológico y micológico se alcanzó el diagnóstico de criptococosis cutánea primaria, lográndose la remisión de las lesiones tras 6 meses de tratamiento con fluconazol.

  6. [Response to everolimus in patients with giant cell astrocytoma associated to tuberous sclerosis complex].

    PubMed

    Mateos-González, M Elena; López-Laso, Eduardo; Vicente-Rueda, Josefina; Camino-León, Rafael; Fernández-Ramos, Joaquín A; Baena-Gómez, M Auxiliadora; Peña-Rosa, M José

    2014-12-01

    Introduccion. Los astrocitomas subependimarios de celulas gigantes (SEGA) se presentan en el 5-20% de los pacientes con complejo esclerosis tuberosa (CET) y son los tumores cerebrales mas comunes en el CET. Son tumores benignos, de estirpe glioneural, que se desarrollan fundamentalmente en las primeras dos decadas de la vida, en general cercanos al foramen de Monro, y pueden ocasionar hidrocefalia e hipertension intracraneal. Constituyen la principal causa de muerte en el CET. Recientemente, los inhibidores mTOR han demostrado ser una alternativa terapeutica a la reseccion quirurgica. Objetivo. Describir nuestra experiencia con everolimus para el tratamiento de pacientes con SEGA y CET. Pacientes y metodos. Estudio prospectivo de la respuesta de los pacientes con CET y al menos un SEGA en crecimiento. Resultados. Recibieron tratamiento tres mujeres y tres varones con una edad media de 12,3 años. Un paciente habia sido previamente intervenido quirurgicamente por SEGA con hidrocefalia. El diametro maximo medio del SEGA al inicio del tratamiento era de 15,3 mm (rango: 11,3-24,8 mm). Se inicio tratamiento con everolimus, 2,5 mg/dia por via oral en pacientes con superficie corporal < 1,2 m2 y 5 mg/dia en pacientes con superficie corporal > 1,2 m2. Dos pacientes presentaron hipertrigliceridemia; uno, anorexia; otro, un afta; y una paciente, amenorrea. La reduccion media del volumen del SEGA a los tres meses de tratamiento fue del 46%, y la reduccion se mantuvo estable en controles posteriores (6-25 meses). Conclusiones. El tratamiento con everolimus disminuye el tamaño de los SEGA asociados a CET con un perfil de seguridad adecuado, y constituye una alternativa a la cirugia en casos seleccionados.

  7. [Oxytocin in the treatment of the social deficits associated to autism spectrum disorders].

    PubMed

    Cachafeiro-Espino, Carla; Vale-Martínez, Anna M

    2015-11-01

    Introduccion. La implicacion de la oxitocina en la conducta social de animales y humanos ha llevado a estudiar los efectos de su administracion en el comportamiento y cognicion social de pacientes con trastornos del espectro autista (TEA). Objetivos. Revisar la investigacion sobre el potencial terapeutico de la oxitocina en el tratamiento de los deficits sociales de la poblacion con TEA y discutir las probables direcciones futuras de los estudios en este campo. Desarrollo. Diversos trabajos han relacionado la oxitocina con la fisiopatologia de los TEA. La mayoria de los estudios que han administrado oxitocina, generalmente por via intranasal (24 UI), ha observado mejoras significativas en el rendimiento social, sin detectar efectos secundarios destacables. No obstante, existen datos contradictorios debido a la heterogeneidad de las variables analizadas por los diferentes estudios, al uso de muestras heterogeneas y pequeñas o a la diferente duracion de los tratamientos. Las limitaciones relacionadas con la falta de comprension de los mecanismos de accion de la oxitocina y la diversidad sintomatologica de los TEA dificultan el establecimiento de este peptido como tratamiento de los pacientes autistas. Estudios recientes destacan la conveniencia de explorar el efecto de la combinacion del tratamiento de oxitocina con programas conductuales de intervencion en habilidades sociales, asi como la potenciacion de la secrecion endogena de oxitocina. Conclusiones. Los efectos de la administracion de oxitocina resultan prometedores en relacion con el tratamiento de los deficits sociales en individuos con TEA. Estudios futuros deberian facilitar la comprension de las vias de accion de la oxitocina y el establecimiento de pautas optimas de tratamiento.

  8. [Nutritional status of patients with cancer of oral cavity].

    PubMed

    Pérez Camargo, Dana Aline; De Nicola Delfín, Luigina; Ñamendys-Silva, Silvio A; Copca Mendoza, Erika Thalia; Hernández Méndez, Margarita; Herrera Gómez, Ángel; Meneses García, Abelardo

    2013-01-01

    Introducción: El cáncer de cavidad oral ocupa el doceavo lugar a nivel mundial. El tratamiento del cáncer de cavidad oral es habitualmente cirugía seguida de radioterapia, la cual puede estar indicada sola o con quimioterapia; este tipo de terapias tienen importantes efectos secundarios funcionales sobre el estado nutricio del paciente. Objetivo: El objetivo de este trabajo es conocer el impacto de los diferentes tratamientos sobre el estado nutricional de los pacientes con cáncer de cavidad oral atendidos en el Instituto Nacional de Cancerología durante el período comprendido del 2009 al 2011. Material y métodos: Se realizó un estudio descriptivo, y retrospectivo. Se incluyeron 99 pacientes con cáncer de cavidad oral. Se registraron las siguientes variables; género, edad, tipo de tratamiento (cirugía, quimioterapia, radioterapia), complicaciones más importantes secundarias a tratamiento, pérdida de peso, índice de masa corporal (IMC) y albumina. Resultados y discusión: La prevalencia de cáncer de cavidad oral fue mayor en mujeres (58,6%); la edad promedio fue de 61,22 años. Las complicaciones secundarias al tratamiento fueron xerostomía (20%) seguida de odinofagia y mucositis (19%), la relación de pérdida de peso y sintomatología se observó en el (54%) de los pacientes, debido al tipo de alimentación previo, durante y después del tratamiento en los cuales tuvo mayor predominio el uso de papillas. Conclusión: Se observó una pérdida de peso debido a las complicaciones del tratamiento médico que afectaron el estado nutricio, por ello es importante tener un monitoreo continuo que apoye el éxito del tratamiento multidisciplinario.

  9. The efficacy and safety of natalizumab for the treatment of multiple sclerosis in Portugal: a retrospective study.

    PubMed

    Sousa, L; de Sa, J; Sa, M J; Cerqueira, J J; Martins-Silva, A

    2014-11-01

    Introduccion. Los estudios han demostrado que el natalizumab constituye un tratamiento eficaz contra la esclerosis multiple remitente recurrente (EMRR). Hasta la fecha, no habia datos de pacientes portugueses. Objetivo. Determinar la eficacia y la seguridad del natalizumab en pacientes con EMRR atendidos en la practica clinica ordinaria en Portugal. Pacientes y metodos. Los datos clinicos de adultos con EMRR tratados con natalizumab en centros especializados de neurologia en Portugal se introdujeron de forma retrospectiva en una base de datos para llevar a cabo un analisis entre octubre de 2010 y febrero de 2012. Se analizo el cambio en la tasa anualizada de brotes (TAB), en las puntuaciones de la escala ampliada de discapacidad (EDSS) y en el estado de discapacidad. Resultados. Se admitio un total de 383 pacientes atendidos en 20 centros. Antes de iniciar el tratamiento con natalizumab, la mediana inicial de la EDSS era de 4,0 y la TAB media, de 1,64. La mayor parte de los pacientes ya habia recibido tratamiento contra la esclerosis multiple (93,0%). La duracion media del tratamiento con natalizumab era de 12 meses. El tratamiento propicio reducciones significativas (p < 0,001) de los valores iniciales de la TAB media y de las puntuaciones EDSS en los tratados con el anticuerpo durante >= 12 meses (n = 288) y durante >= 24 meses (n = 160). El natalizumab resulto mas eficaz en los pacientes que presentaban un menor grado de discapacidad (EDSS < 3,0) y en los que no habian recibido ningun tratamiento modificador de la enfermedad. Se notificaron dos casos de leucoencefalopatia multifocal progresiva. No hubo efectos adversos inesperados. Conclusion. El natalizumab presenta una tolerabilidad satisfactoria y se muestra eficaz en la reduccion de las recidivas y la estabilizacion de la EMRR en el marco de la practica clinica ordinaria en Portugal. Conserva su eficacia con el tratamiento continuado y podria ser eficaz especialmente en los pacientes con menos discapacidad y

  10. [Evaluation of the quality of scientific evidence of pharmaceutical interventions in an emergency department].

    PubMed

    Pérez León, M; Alonso Ramos, H; González Munguía, S; Marrero Penichet, S M; Molero Gómez, R

    2014-03-01

    Objetivo: Evaluar la calidad de las intervenciones farmacéuticas que motivaron un inicio de tratamiento en un Servicio de Urgencias. Analizar el porcentaje de intervenciones sobre tratamientos agudos o crónicos, y el grupo ATC de los fármacos implicados. Método: Se analizaron y clasificaron las intervenciones farmacéuticas realizadas durante un año, asignándoles el grado de recomendación, nivel de evidencia y reducción de la morbimortalidad teórica asociada según las guías de práctica clínica. También fueron clasificadas según el objetivo del tratamiento de la intervención (agudo o crónico), y por el grupo ATC. Resultado: Se realizaron 2.776 intervenciones farmacéuticas durante el período de estudio, siendo el 47% intervenciones de inicio de tratamiento. El 73% pudieron ser clasificadas según la evidencia científica disponible en las guías de práctica clínica. El 84% obtuvo un grado de recomendación y nivel de evidencia IA, el 9% IC y 4% IB. El 67% tenían asociada una disminución teórica de la morbimortalidad. El 73% de las intervenciones estuvieron relacionadas con el tratamiento crónico del paciente, siendo los grupos ATC más frecuentes el N y C. Mientras que en los tratamientos agudos los más frecuentes fueron el grupo B y A. Conclusiones: Las intervenciones de inicio de tratamiento realizadas por un farmacéutico clínico en el Servicio de Urgencias muestran una elevada adherencia a las guías de práctica clínica con un alto grado de recomendación y evidencia, y reducción teórica de la morbimortalidad asociada. La mayoría de las intervenciones estuvieron relacionadas con la conciliación de tratamientos crónicos, fundamentalmente fármacos del grupo N y C.

  11. Entérite lupique récidivante améliorée par Azathioprine

    PubMed Central

    Marzouk, Sameh; Garbaa, Saida; Cherif, Yosra; Jallouli, Moez; Bahri, Fathi; Bahloul, Zouhir

    2015-01-01

    Les manifestations gastro-intestinales observées au cours du lupus érythémateux systémique sont fréquentes et peuvent intéresser n'importe quel segment du tractus digestif. L'entérite lupique constitue l'une des manifestations responsable de douleurs abdominales. Son traitement est basé essentiellement sur les corticoïdes. Le recours aux immunosuppresseurs est réservé aux formes récidivantes ou en cas d’échec des corticoïdes. Nous rapportons une nouvelle observation d'entérite lupique récidivante améliorée par azathioprine. Il s'agissait d'une femme âgée de 30 ans chez laquelle le diagnostic du lupus a été retenu en 2004. Un an après, elle a présenté des douleurs abdominales, des vomissements et des diarrhées. Les explorations ont conclu à une entérite lupique après élimination de toute autre cause notamment infectieuse. Elle a été traitée par des corticoïdes à forte dose. Cependant à chaque tentative de dégression, elle présentait la même symptomatologie. En 2010 l'azathioprine a été associé permettant de juguler la maladie et de diminuer la corticothérapie. PMID:26113946

  12. Tumores extracraneales de células germinativas—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del tumor extracraneal de células germinativas en los niños, así como referencias a estudios clínicos y otros temas relacionados.

  13. Hacer frente - Para la familia y los amigos

    Cancer.gov

    Si usted ayuda a su familiar o amigo durante el tratamiento del cáncer, usted es quien le cuida. Estar al cuidado de una persona con cáncer puede incluir muchas tensiones. Sugerencias para que se cuide usted cuando cuida a otros.

  14. Jóvenes con cáncer y supervivientes participan en estudio de oncofertilidad

    Cancer.gov

    Artículo sobre los esfuerzos que se realizan para conectar con pacientes jóvenes y lograr su participación en estudios clínicos para evaluar y remediar la esterilidad causada por el cáncer y su tratamiento.

  15. Sarcoma de tejido blando—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del sarcoma de tejido blando, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  16. Cáncer de vesícula biliar—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de vesícula biliar, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  17. Cáncer de pene—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de pene, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  18. Cáncer de páncreas—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de páncreas, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  19. Cáncer de testículo—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, las causas y los exámenes de detección del cáncer de testículo, así como referencias a estudios clínicos, investigación y otros temas.

  20. Cáncer de vulva—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de vulva, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  1. Cáncer de pene—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de pene, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  2. Cáncer de testículo—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, las causas y los exámenes de detección del cáncer de testículo, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  3. Cáncer de paratiroides—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de paratiroides, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  4. Estudio muestra reducción de mortalidad en hombres con cáncer de próstata de grado intermedio

    Cancer.gov

    Terapia hormonal por corto tiempo administrada en combinación con radioterapia a hombres con cáncer de próstata en estadio inicial aumentó sus posibilidades de vivir más en comparación con tratamiento de radioterapia sola, según un estudio clínico patroci

  5. Neuropatía persistente aumenta el riesgo de caídas entre supervivientes de cáncer

    Cancer.gov

    Muchas mujeres supervivientes de cáncer tienen problemas de movilidad y de otras funciones físicas como resultado de la neuropatía periférica persistente causada por el tratamiento de quimioterapia, según un estudio nuevo.

  6. [Non-speech oral motor treatment efficacy for children with developmental speech sound disorders].

    PubMed

    Ygual-Fernandez, A; Cervera-Merida, J F

    2016-01-01

    Introduccion. En el tratamiento logopedico de las dificultades de habla se practican dos enfoques metodologicos antagonicos: los no verbales, basados en ejercicios de motricidad oral (EMO), y los verbales, que se basan en tareas de procesamiento de habla con silabas, fonemas y palabras. En España, los programas de EMO se llaman 'programas de praxias', estan muy difundidos y son apreciados por los logopedas. Objetivo. Revisar los estudios sobre la eficacia de los tratamientos basados en EMO aplicados a niños con trastornos de habla y los argumentos teoricos que podrian justificar o no su utilidad. Desarrollo. Durante las ultimas decadas se han acumulado pruebas sobre la falta de eficacia de este enfoque en el tratamiento de los trastornos evolutivos del habla y en las dificultades de pronunciacion de poblaciones sin alteracion neurologica de la funcion motriz. La American Speech-Language-Hearing Association ha desaconsejado su uso atendiendo a los principios de practica basada en la evidencia. Los conocimientos acumulados sobre el control motor demuestran que el patron de movilidad y su correspondiente organizacion cerebral son diferentes en el habla y en otras funciones no verbales ligadas a la alimentacion y la respiracion. Conclusiones. Ni los estudios sobre su eficacia ni los argumentos a partir de estudios del control motor aconsejan el uso de los programas basados en EMO para el tratamiento de las dificultades de pronunciacion en niños con trastornos evolutivos del lenguaje.

  7. Neoplasias de células plasmáticas (incluso mieloma múltiple)—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del mieloma múltiple y otras neoplasias de células plasmáticas, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  8. Lo que usted necesita saber sobre™ el cáncer de cérvix

    Cancer.gov

    Contiene información sobre las opciones de tratamiento, la obtención de una segunda opinión, los cuidados de seguimiento y las fuentes de apoyo para alguien que ha sido diagnosticado recientemente con cáncer de cérvix o cuello uterino.

  9. Lo que usted necesita saber sobre™ el cáncer de seno

    Cancer.gov

    Contiene información sobre las opciones de tratamiento, los diferentes médicos que tratan el cáncer de seno, la obtención de una segunda opinión, los cuidados de seguimiento y las fuentes de apoyo para alguien que ha sido diagnosticado recientemente con c

  10. Fatiga (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca de la fatiga, una afección caracterizada por extremo cansancio e incapacidad para funcionar por la falta de energía, que a menudo se observa como una complicación del cáncer y su tratamiento.

  11. Tensión postraumática relacionada con el cáncer (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca de la tensión postraumática y síntomas relacionados en los pacientes con cáncer, sobrevivientes del cáncer y miembros de la familia. Se discuten la evaluación y tratamiento de estos síntomas.

  12. Delirio (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca del delirio como una complicación a causa del cáncer o su tratamiento. Se discuten los enfoques de los cuidados médicos de apoyo, asi como farmacológicos para el manejo del delirio.

  13. Tumores cerebrales—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento de los tumores cerebrales, así como referencias a estudios clínicos, estadísticas y otros temas relacionados con estos tipos de cáncer.

  14. El NCI inicia un estudio para evaluar la utilidad de la secuenciación genética para mejorar los resu

    Cancer.gov

    El Instituto Nacional del Cáncer (NCI) lanzará este mes un estudio clínico piloto denominado M-PACT con la finalidad de evaluar si el tratamiento asignado según mutaciones genéticas específicas puede brindar beneficios a pacientes con tumores sólidos meta

  15. Cáncer de intestino delgado—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de intestino delgado, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  16. Cáncer de intestino delgado—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de intestino delgado, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  17. Leucemia—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento de la leucemia, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  18. Cáncer de hígado y de conducto biliar—Versión para profesionales de salud

    Cancer.gov

    Información del NCI para profesionales de salud sobre el tratamiento, la prevención y los exámenes de detección del cáncer de hígado y de conducto biliar, así como referencias a estudios clínicos, investigación y otros temas.

  19. Leucemia—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento de la leucemia, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  20. [Analysis of the causes leading to withdrawal of the treatment with triple antiviral therapy for hepatitis C patients].

    PubMed

    Ruiz Ramos, J; Lorente Fernández, L; Gil Gómez, I; Cueto Sola, M; Monte Boquet, E; Poveda Andrés, J L

    2014-05-01

    Objetivo: Evaluar las causas de suspensión de tratamientofrente a Hepatitis C que reciben triple terapia antiviral (peginterferon+ ribavirina + inhibidor de proteasa).Métodos: Estudio observacional retrospectivo de pacientes queiniciaron triple terapia antiviral entre enero 2012 - marzo 2013y suspendieron el tratamiento antes de completar el mismo.Resultados: De 156 pacientes que iniciaron triple terapia, 41interrumpieron el tratamiento: Diecinueve por toxicidad, siendodermatológica en siete pacientes (36,8%), intolerancia en seis(31,6%) y hematológica en cuatro (15,8%). Dieciséis pacientessuspendieron todo el tratamiento por ineficacia. El grupo depacientes con mayor porcentaje de fracasos por ineficacia fueronlos “no respondedores” (32,3%) mientras que el grupo depacientes “recidivantes” fueron el grupo con mayor porcentajede suspensiones por toxicidad (15,6%). Dos pacientes fallecierondurante el tratamiento por neumonía.Conclusiones: La triple terapia frente a VHC está asociada a unnúmero importante de fracasos terapéuticos tanto por toxicidadcomo por ineficacia.

  1. [Autism spectrum disorder and epilepsy: the role of ketogenic diet].

    PubMed

    Garcia-Penas, J J

    2016-01-01

    Introduccion. Un 5-40% de los pacientes autistas desarrolla epilepsia. Aunque generalmente se controlan bien con medicacion, hasta un 20-30% de estas epilepsias son refractarias al tratamiento farmacologico. En esta poblacion, la dieta cetogenica (DC) puede ser una terapia alternativa altamente eficaz y debe considerarse seriamente. Objetivo. Revisar el papel de la DC en el tratamiento de la epilepsia infantil refractaria y en los pacientes que asocian autismo y epilepsia. Desarrollo. La DC es un tratamiento eficaz y bien tolerado para las epilepsias infantiles refractarias, incluyendo los pacientes que asocian autismo y epilepsia. Es fundamental caracterizar de forma precisa el sindrome epileptico para conocer cuales son los mejores candidatos para tratar con DC. Por otra parte, el efecto positivo de la DC sobre las alteraciones del metabolismo oxidativo mitocondrial y la evidencia experimental obtenida con DC en animales autistas sugieren que pueda ser una alternativa eficaz en los pacientes con autismo. Conclusiones. Basandose en la utilidad demostrada de la DC en el tratamiento de pacientes con epilepsia y autismo, esta terapia se ha usado en los ultimos años como una terapia alternativa para los pacientes autistas, aunque se desconoce cual es su eficacia real. Es necesario realizar un estudio aleatorizado y controlado para definir el perfil de eficacia y seguridad en esta poblacion.

  2. [Therapeutic plasma exchange: applications in neurology].

    PubMed

    Láinez-Andrés, José M; Gascón-Giménez, Francisco; Coret-Ferrer, Francisco; Casanova-Estruch, Bonaventura; Santonja, José M

    2015-02-01

    Introduccion. El recambio plasmatico es una tecnica utilizada en el tratamiento de algunas enfermedades neurologicas de base autoinmune desde los años ochenta, especialmente en situaciones agudas. En los ultimos años se han publicado nuevos datos sobre su empleo en numerosas entidades con base autoinmune, ampliando, con ello, el espectro de utilizacion. Objetivo. Actualizar las indicaciones de esta tecnica en el tratamiento de las enfermedades neurologicas. Desarrollo. Se ha realizado una revision exhaustiva de todos los articulos publicados desde los años ochenta sobre la eficacia del recambio plasmatico en el tratamiento de las diferentes enfermedades neurologicas. Tambien se ha efectuado un analisis detallado de las recomendaciones y evidencias de la utilizacion de este procedimiento por parte de las diferentes sociedades cientificas. Conclusiones. El recambio plasmatico ha demostrado ser una alternativa eficaz con evidencia cientifica de primer nivel en enfermedades como el sindrome de Guillain-Barre, la polineuropatia desmielinizante inflamatoria cronica o la miastenia grave. Ha mostrado ser eficaz en el tratamiento de episodios desmielinizantes agudos sin respuesta a otras terapias, en los brotes de neuromielitis optica y en otras enfermedades del sistema nervioso central producidas por anticuerpos. En los estudios comparativos con inmunoglobulinas intravenosas, la eficacia de ambas terapias es similar. Es preciso seguir realizando estudios comparativos para conocer mejor los mecanismos y establecer indicaciones prioritarias y comparar la relacion coste-eficacia de ambos procedimientos.

  3. Cáncer de útero—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer uterino, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  4. Terapia hormonal para el cáncer de próstata Hoja informativa

    Cancer.gov

    Hoja informativa que describe la terapia hormonal y su función en el tratamiento del cáncer de próstata. Incluye información acerca de los tipos diferentes de terapia hormonal, cómo se usan y los efectos secundarios posibles.

  5. Iniciativa de Respuestas Excepcionales: Preguntas y respuestas

    Cancer.gov

    El Instituto Nacional del Cáncer (NCI) emprendió la Iniciativa de Respuestas Excepcionales a fin de entender la base molecular de los tumores en pacientes de cáncer que responden en forma excepcional al tratamiento, principalmente quimioterapia.

  6. Mesotelioma maligno—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento y las causas del mesotelioma maligno, así como referencias a estudios clínicos y otros temas relacionados con este tipo de cáncer.

  7. Tumores extracraneales de células germinativas—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del tumor extracraneal de células germinativas en los niños, así como referencias a estudios clínicos y otros temas relacionados.

  8. Cáncer de cabeza y cuello—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección de los cánceres de cabeza y cuello, así como referencias a estudios clínicos, investigaciones, estadísticas y temas relacionados.

  9. Neoplasias mielodisplásicas o mieloproliferativas (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca del tratamiento de las neoplasias mielodisplásicas o mieloproliferativas, incluso las leucemias mielomonocítica crónica o juvenil y la LMC atípica.

  10. Neoplasias mielodisplásicas o mieloproliferativas (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca del tratamiento de las neoplasias mielodisplásicas o mieloproliferativas, incluso las leucemias mielomonocíticas crónicas o juveniles, y la LMC atípica.

  11. [Temporal lobe epilepsy and active neurocysticercosis: two representative case reports].

    PubMed

    Ramos-Zúñiga, Rodrigo; Pérez-Gómez, Héctor R; Gaytán-Martínez, Luis A; Vega-Ruiz, Brenda; Soto-Rodríguez, Sofía; Rochín-Mozqueda, Alejandro

    2015-01-01

    Introduccion. Existen pocas evidencias notificadas de casos de epilepsia del lobulo temporal asociadas a cisticercosis activa en su fase quistica. El objetivo es presentar la correlacion entre cisticercosis activa en zonas topograficas asociadas a epilepsia del lobulo temporal, con las manifestaciones neuropsiquiatricas y el patron de crisis parciales secundariamente generalizadas. Casos clinicos. Dos casos de pacientes adultos con manifestaciones neuropsiquiatricas de un año de evolucion, refractarios a tratamiento farmacologico antipsicotico, y en quienes posteriormente aparecen crisis convulsivas parciales secundariamente generalizadas de inicio tardio. Se identifica la presencia de cisticercosis activa en el lobulo temporal en un paciente, y en la insula, en el otro. Buen control clinico posterior al tratamiento con albendazol, pero se mantiene el mismo tratamiento anticonvulsionante para considerar la pertinencia de su retirada farmacologica. Conclusiones. La neurocisticercosis activa puede ser causa de trastornos neuropsiquiatricos adquiridos y de epilepsia del lobulo temporal de inicio tardio cuando su topografia se encuentra en el circuito mesolimbico. El diagnostico etiologico oportuno y el tratamiento apropiado permiten el control adecuado de su sintomatologia y, potencialmente, su curacion definitiva.

  12. [Progressive multifocal leukoencephalopathy associated to natalizumab: the importance of magnetic resonance imaging in its early diagnosis].

    PubMed

    Martí, Glòria; Río, Jordi; Rovira, Àlex; Auger, Cristina; Tintoré, Mar; Sastre-Garriga, Jaume; Vidal, Anka; Castilló, Joaquín; Montalban, Xavier

    2015-02-16

    Introduccion. El natalizumab es un farmaco utilizado en la esclerosis multiple (EM), cuyo principal efecto adverso es el desarrollo de una leucoencefalopatia multifocal progresiva (LMP). Como esta es potencialmente mortal o discapacitante, el tratamiento debe suspenderse inmediatamente ante su sospecha, teniendo en cuenta el posible desarrollo posterior de un sindrome de reconstitucion inmune o rebrote de la EM. Caso clinico. Se describe un caso de LMP, inicialmente asintomatico, en el contexto del tratamiento con natalizumab en una paciente con EM. Como factores de riesgo se determinaron titulos altos de anticuerpos contra el virus John Cunningham (VJC) y mas de dos años de tratamiento. La reaccion en cadena de la polimerasa para el VJC en el liquido cefalorraquideo resulto negativa en dos determinaciones. El periodo entre el diagnostico radiologico y el inicio de la clinica fue de dos meses. Durante el curso de la enfermedad, la paciente desarrollo un sindrome inflamatorio de reconstitucion inmune y rebrotes de su EM. Presento una buena respuesta tras el inicio de tratamiento con fingolimod, una vez estabilizada la LMP. Conclusion. Este caso ilustra la importancia de una estrecha vigilancia clinicorradiologica en pacientes con EM tratados con natalizumab, sobre todo cuando presentan factores de riesgo para el desarrollo de LMP, asi como su potencial incidencia en la supervivencia y estado funcional final.

  13. Sarcoma de tejido blando—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del sarcoma de tejido blando, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  14. Cáncer de tiroides—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de tiroides, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  15. Retinoblastoma—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del retinoblastoma, así como referencias a estudios clínicos, estadísticas y otros temas relacionados con este tipo de cáncer.

  16. Cáncer de ano—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de ano, así como referencias a estudios clínicos y otros temas relacionados con este tipo de cáncer.

  17. Cáncer de útero—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer uterino, así como referencias a estudios clínicos, investigación, estadísticas y otros temas.

  18. Enfermedad trofoblástica de la gestación—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento de la enfermedad trofoblástica de la gestación, así como referencias a estudios clínicos y otros temas relacionados.

  19. Cáncer de vagina—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de vagina, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  20. Cáncer de la corteza suprarrenal—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del carcinoma de corteza suprarrenal, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  1. Cáncer de uretra—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de uretra, así como referencias a estudios clínicos y otros temas relacionados con este tipo de cáncer.

  2. Cáncer de vejiga—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, las causas y los exámenes de detección del cáncer de vejiga, así como referencias a estudios clínicos, investigación, estadísticas y otros temas.

  3. Cáncer de piel (incluye el melanoma)—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas, los exámenes de detección y los estudios clínicos del cáncer de piel, así como referencias a otros temas relacionados con este tipo de cáncer.

  4. Cánceres poco comunes en la niñez (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca del tratamiento de los cánceres poco comunes en la niñez como los cánceres de la cabeza y el cuello, el tórax, el abdomen, el aparato reproductor, la piel y otros.

  5. [Effects of exenatide lar in type 2 diabetes mellitus and obesity].

    PubMed

    Sierra Poyatos, Roberto; Riobó Serván, Pilar; Vázquez Martínez, Clotilde

    2014-10-24

    Introducción: Los análogos GLP-1 han demostrado ser un tratamiento eficaz en el tratamiento de la diabetes mellitus tipo 2 (DM-2) y la obesidad. Objetivo: Evaluar la eficacia de exenatide LAR sobre la pérdida de peso, control glucémico, tensión arterial (TA) y perfil lipídico, en DM-2 y obesidad. Material y métodos: Estudio retrospectivo de pacientes en tratamiento con exenatide LAR durante 6 meses. Se recogieron datos demográficos (edad, sexo), antropométricos, glucemia basal, hemoglobina glicada (HbA1c), tensión arterial y perfil lipídico al inicio y a los 6 meses de tratamiento. Se ha realizado un análisis de regresión logística para evaluar posibles factores predictores de eficacia. Resultados: 30 pacientes (17 varones, edad media: 61,7±9,5 años) con DM-2 de 9,7±6,2 años de evolución. La HbA1c se redujo en 1,3% (IC95% 1,04-1,57, p.

  6. [Prevalence of antiparkinsonian treatment complications: a systematic review and estimation of projections].

    PubMed

    Fernández-Sanchis, Daniel; Frutos Pérez-Surio, Alberto Frutos; López del Val, Luis J

    2015-08-01

    Introduccion. El desarrollo de la enfermedad de Parkinson (EP) presenta diferentes complicaciones derivadas de la propia enfermedad, pero tambien de su tratamiento. La aparicion de efectos adversos con el uso de antiparkinsonianos es comun y su manejo es complicado, por lo que se hace necesario determinar el impacto epidemiologico de estos problemas relacionados con los medicamentos antiparkinsonianos. Objetivo. Estimar la prevalencia de los efectos adversos del tratamiento de los sintomas motores de la EP y su posible impacto a largo plazo. Pacientes y metodos. Se realizo una revision sistematica en bases de datos biomedicas desde el año 2004; se seleccionaron los estudios mas relevantes y se identificaron las frecuencias de los efectos adversos mas comunes. Se proyectaron los datos obtenidos para estimar su impacto a largo plazo. Resultados. Se identificaron 218 estudios, de los cuales 24 fueron seleccionados para la revision. Se obtuvieron datos para 20 tipos de complicaciones del tratamiento antiparkinsoniano, entre las que se encuentran problemas cardiacos, edemas y sintomas neuropsiquiatricos. Conclusion. Las estimaciones realizadas indican que el numero de pacientes de EP y, consecuentemente, la prevalencia de los efectos adversos de los tratamientos antiparkinsonianos pueden duplicarse en el año 2050.

  7. Tensión postraumática relacionada con el cáncer (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca de la tensión postraumática y los síntomas relacionados en los pacientes con cáncer, sobrevivientes del cáncer y miembros de la familia. Se discuten la evaluación y el tratamiento de estos síntomas.

  8. Delirio (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca del delirio como una complicación del cáncer o su tratamiento. Se tratan enfoques de los cuidados médicos de apoyo y los abordajes farmacológicos para el manejo del delirio.

  9. Náuseas y vómitos (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca de las náuseas y los vómitos como complicaciones a causa del cáncer o su tratamiento. Se discuten enfoques sobre el manejo de las náuseas y los vómitos.

  10. Hacer frente - Su imagen propia y su sexualidad

    Cancer.gov

    El cáncer y su tratamiento pueden cambiar la forma como usted se ve y siente de su persona y de su cuerpo. Puede tomar algunas medidas para superar los cambios de su cuerpo y problemas relacionados con su sexualidad e intimidad.

  11. Hacer frente - Los sentimientos y el cáncer

    Cancer.gov

    El cáncer puede causar una amplia gama de sentimientos, ya sea que usted, un amigo o familiar esté en tratamiento ahora o que ya lo haya completado. Sugerencias para superar las muchas emociones causadas por el cáncer.

  12. Capacitación del personal y de los pacientes en torno a los cuidados terminales

    Cancer.gov

    Artículo sobre programas innovadores de base científica para ayudar a médicos y pacientes a hablar sobre la transición de un tratamiento activo para el cáncer a los cuidados en la etapa final de la vida.

  13. Fatiga (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca de la fatiga, una afección caracterizada por extremo cansancio e incapacidad para funcionar por la falta de energía, que a menudo se observa como una complicación del cáncer y su tratamiento.

  14. Náuseas y vómitos (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca de las náuseas y los vómitos como complicaciones a causa del cáncer o su tratamiento. Se discuten enfoques sobre el manejo de las náuseas y los vómitos.

  15. [Response to treatment with interferon beta in patients with multiple sclerosis. Validation of the Rio Score].

    PubMed

    Rio, J; Rovira, A; Blanco, Y; Sainz, A; Perkal, H; Robles, R; Ramio-Torrenta, Ll; Diaz, R M; Arroyo, R; Urbaneja, P; Fernandez, O; Garcia-Merino, J A; Reyes, M P; Oreja-Guevara, C; Prieto, J M; Izquierdo, G; Olascoaga, J; Alvarez-Cermeno, J C; Simon, E; Pujal, B; Comabella, M; Montalban, X

    2016-08-16

    Introduccion. Se han propuesto diferentes criterios de respuesta al tratamiento con interferon beta, y el Rio Score es uno de los mas utilizados. El objetivo de este estudio fue validar la utilidad del Rio Score en una cohorte independiente. Pacientes y metodos. Estudio multicentrico, prospectivo y longitudinal de pacientes con esclerosis multiple remitente recurrente tratados con interferon beta. Los pacientes fueron clasificados basandose en la presencia de brotes, lesiones activas (nuevas en T2 o lesiones que captaban gadolinio) en la resonancia magnetica, incremento confirmado de la discapacidad o combinaciones de estas variables (brotes, incremento en la Expanded Disability Status Scale y lesiones activas) tras un año de tratamiento. Se utilizo un analisis de regresion con el fin de identificar las variables de prediccion de respuesta despues de un seguimiento de tres años. Resultados. Se incluyo a 249 pacientes con esclerosis multiple remitente recurrente. El modelo logistico confirmo que la presencia de dos (odds ratio = 6,6; IC 95% = 2,7-16,1; p < 0,0001) o tres (odds ratio = 8,5; IC 95% = 1,6-46; p < 0,01) variables positivas durante el primer año de tratamiento conferia un riesgo significativo de actividad (brotes o progresion) en los siguientes dos años. Conclusiones. Se confirma, en una cohorte independiente, la utilidad del Rio Score para identificar a pacientes con un mayor riesgo de desarrollar actividad clinica o progresion de la discapacidad durante el tratamiento con interferon beta.

  16. Cáncer de vesícula biliar—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de vesícula biliar, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  17. Tipos de cáncer

    Cancer.gov

    Lista alfabética de todos los tipos de cáncer con enlaces a enfermedades específicas e información general sobre tratamiento, cuidados de apoyo, exámenes de detección, prevención, estudios clínicos y otros temas.

  18. Qué tipos hay de estudios clínicos

    Cancer.gov

    Información sobre los diversos tipos de estudios clínicos de cáncer, como son los estudios de tratamiento, de prevención, de exámenes selectivos de detección, de cuidados médicos de apoyo y de cuidados paliativos.

  19. Cáncer de vulva—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de vulva, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  20. Linfoma—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del linfoma, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  1. Neoplasias de células plasmáticas (incluso mieloma múltiple)—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del mieloma múltiple y otras neoplasias de células plasmáticas, así como referencias a estudios clínicos, investigación, estadísticas y otros temas.

  2. Cáncer de riñón (células renales)—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de riñón, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  3. Cáncer de piel (incluye el melanoma)—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de piel, así como referencias a estudios clínicos, investigación y otros temas.

  4. Cáncer colorrectal—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de colon y recto, así como referencias a estudios clínicos, estadísticas y otros temas.

  5. Se lanza Red Nacional de Estudios Clínicos del NCI

    Cancer.gov

    El Instituto Nacional del Cáncer (NCI) puso en marcha una nueva red de investigación de estudios clínicos con el objetivo de mejorar el tratamiento de más de 1,6 millones de estadounidenses que reciben un diagnóstico de cáncer cada año.

  6. Neuroblastoma—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento y los exámenes de detección del neuroblastoma, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  7. Neuroblastoma—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento y los exámenes de detección del neuroblastoma, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  8. El cáncer

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, los exámenes de detección, la genética y las causas del cáncer, así como formas de hacer frente a la enfermedad.

  9. FDA aprueba la primera inmunoterapia para linfoma

    Cancer.gov

    La FDA ha aprobado nivolumab (Opdivo®) para el tratamiento de pacientes con el linfoma clásico de Hodgkin que ha recaído o empeorado después de recibir un trasplante autólogo hematopoyético seguido de brentuximab vedotin (Adcetris®)

  10. Cáncer de riñón (células renales)—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de riñón, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  11. Linfoma—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del linfoma, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados con este tipo de cáncer.

  12. Cáncer de vagina—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de vagina, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  13. Cáncer de páncreas—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de páncreas, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  14. Cáncer de paratiroides—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de paratiroides, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  15. Cáncer de cuello uterino—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de cuello uterino, así como referencias a estudios clínicos, investigación, estadísticas y otros temas relacionados.

  16. Cáncer de tiroides—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de tiroides, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  17. Cáncer colorrectal—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento, la prevención, las causas y los exámenes de detección del cáncer de colon y recto, así como referencias a estudios clínicos, estadísticas y otros temas relacionados.

  18. Tumores cerebrales—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento de los tumores cerebrales, así como referencias a estudios clínicos, estadísticas y otros temas relacionados con estos tipos de cáncer.

  19. El equilibrio correcto: cómo ayudar a los supervivientes de cáncer a tener un peso saludable

    Cancer.gov

    Artículo sobre las intervenciones que buscan ayudar a los supervivientes a mantener un peso saludable para reducir la recidiva y la muerte por cáncer, y disminuir la probabilidad de padecer efectos tardíos y crónicos del tratamiento.

  20. Personal de enfermería asume diversas funciones con expansión de programas de gestión para pacientes

    Cancer.gov

    Artículo sobre los profesionales de enfermería oncológica que ayudan a los pacientes durante todas las etapas de la atención oncológica, desde los exámenes de detección y el diagnóstico, hasta el tratamiento y la supervivencia.

  1. Hacer frente - Obtener cuidados médicos de seguimiento

    Cancer.gov

    Información sobre los cuidados médicos de seguimiento después del tratamiento del cáncer. Trata sobre su plan de cuidados de seguimiento, cómo obtener un plan para el bienestar e incluye una guía para una vida saludable.

  2. Mesotelioma maligno—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento y las causas del mesotelioma maligno, así como referencias a estudios clínicos y otros temas relacionados con este tipo de cáncer.

  3. Misión contra el Cáncer

    Cancer.gov

    La Misión contra el Cáncer, dirigida por el vicepresidente Joe Biden, alineará recursos del gobierno federal para acelerar el progreso en investigación de cáncer y conducirá a una mejor prevención, detección y tratamiento del cáncer.

  4. Centro para la Salud Mundial del NCI anuncia becas de investigación para tecnologías portátiles

    Cancer.gov

    El Centro para la Salud Mundial del NCI (CGH) anunció el otorgamiento de subvenciones que apoyarán el desarrollo y la validación de tecnologías portátiles y de bajo costo para mejorar la detección temprana, el diagnóstico y el tratamiento del cáncer.

  5. Cáncer de hueso—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del cáncer de hueso (óseo), así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  6. Cáncer de hueso—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del cáncer de hueso (óseo), así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  7. Cuidados médicos de apoyo en niños (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca de la peculiaridad de los asuntos que surgen durante y después del tratamiento en los niños con cáncer, y como sobrevivientes adultos de cáncer.

  8. Cánceres poco comunes en la niñez (PDQ®)—Versión para pacientes

    Cancer.gov

    Resumen de información revisada por expertos acerca del tratamiento de los cánceres poco comunes en la niñez como los cánceres de la cabeza y el cuello, el tórax, el abdomen, el aparato reproductor, la piel y otros.

  9. Tumores de hipófisis—Versión para profesionales de salud

    Cancer.gov

    Información del Instituto Nacional del Cáncer para profesionales de salud sobre el tratamiento del tumor de hipófisis, así como referencias a estudios clínicos, investigación y otros temas relacionados.

  10. Cuidados médicos de apoyo en niños (PDQ®)—Versión para profesionales de salud

    Cancer.gov

    Resumen de información revisada por expertos acerca de la peculiaridad de los asuntos que surgen durante y después del tratamiento en los niños con cáncer y como sobrevivientes adultos de cáncer.

  11. Añadir quimioterapia después de la radioterapia mejora la supervivencia de adultos con un tipo de tu

    Cancer.gov

    Adultos con gliomas de grado bajo, una forma de tumor cerebral, que recibieron tratamiento con quimioterapia después de la radioterapia vivieron más tiempo que pacientes que recibieron solo radioterapia, según los resultados de seguimiento a largo plazo d

  12. Neuropatía periférica inducida por quimioterapia

    Cancer.gov

    Artículo sobre un efecto secundario de la quimioterapia que causa dolor y malestar en las manos y los pies. También incluye información sobre los esfuerzos para mejorar las opciones de detección, tratamiento y prevención.

  13. [Consensus document on spasticity in patients with multiple sclerosis. Grupo de Enfermedades Desmielinizantes de la Sociedad Española de Neurología].

    PubMed

    Oreja-Guevara, Celia; Montalban, Xavier; de Andrés, Clara; Casanova-Estruch, Bonaventura; Muñoz-García, Delicias; García, Inmaculada; Fernández, Óscar

    2013-10-16

    Introduccion. La esclerosis multiple es una enfermedad neurologica cronica, desmielinizante e inflamatoria. Los neurologos implicados en el tratamiento sintomatico de esta enfermedad tienden a aplicar criterios diagnosticos y de tratamiento heterogeneos. Objetivo. Elaborar un documento de consenso para establecer criterios homogeneos para el tratamiento de la espasticidad, basados en el conocimiento cientifico disponible que faciliten la toma de decisiones en la practica clinica habitual. Desarrollo. Un grupo de expertos españoles en esclerosis multiple del Grupo de Enfermedades Desmielinizantes de la Sociedad Española de Neurologia (SEN) se reunieron para revisar los aspectos relacionados con la espasticidad en esta enfermedad y elaborar el consenso. Tras una busqueda bibliografica exhaustiva y siguiendo la metodologia metaplan se establecieron unas recomendaciones preliminares para incorporar al documento. Finalmente, cada argumento se clasifico segun su grado de recomendacion, atendiendo a las categorias del sistema SIGN (Scottish Intercollegiate Guidelines Network). El texto resultante fue sometido a la revision de los miembros del Grupo de Enfermedades Desmielinizantes de la SEN. Se ha alcanzado un consenso de expertos respecto a los factores desencadenantes de la espasticidad, la sintomatologia relacionada, los criterios diagnosticos, los metodos de valoracion de la espasticidad, la calidad de vida y los criterios en el manejo terapeutico (farmacologicos y no farmacologicos). Conclusion. Las recomendaciones contenidas en este consenso pueden ser una herramienta util para el neurologo para la practica clinica del dia a dia y para mejorar la calidad de vida del paciente, ya que permiten un mejor diagnostico y tratamiento de la espasticidad.

  14. [Subconjunctival chemotherapy in patients with acquired immunodeficiency syndrome. Experimental study of 3 clinical cases].

    PubMed

    Melgares-Ramos, María de los Ángeles; Carnesoltas-Lázaro, Deyanira; Silveira-Melgares, Yiliam Suyen; Domínguez-Odio, Aníbal

    2015-01-01

    Introducción: el carcinoma escamoso de la conjuntiva (CEC) es un tumor maligno epitelial de la mucosa conjuntival, de etiología multifactorial. Existen varias alternativas de tratamiento para el control de esta enfermedad con diferentes resultados terapéuticos. El objetivo del trabajo fue evaluar la respuesta antitumoral de la preparación de una formulación de cisplatino en 3 pacientes con HIV y CEC recidivante, candidatos a tratamiento de enucleación y exenteración orbitaria, y evaluar los efectos adversos que se presentaron con la administración de la formulación aplicada. Métodos: fueron tratados 3 pacientes masculinos, caucásicos, con media de edad 37 años, a los que se les realizó cirugía exerética y se les administraron 3 ciclos de quimioterapia subconjuntival, con duración de 3 meses. Resultados: todos los pacientes conservaron sus ojos y la visión. No hubo persistencia ni aparecieron recidivas tumorales durante el periodo evaluado. Un paciente falleció por progresión del HIV 2 años después de finalizado el tratamiento, mantuvo visión conservada y sin actividad tumoral. Conclusión: el tratamiento con quimioterapia subconjuntival adyuvante a la cirugía resulta eficaz y es tolerable en la población de pacientes tratados.

  15. Terapia hormonal para el cáncer de seno

    Cancer.gov

    Hoja informativa que describe la terapia hormonal y su función en la prevención y tratamiento del cáncer de seno. Incluye información acerca de los efectos secundarios posibles y de los fármacos que pueden interferir con la terapia hormonal.

  16. Cáncer de la corteza suprarrenal—Versión para pacientes

    Cancer.gov

    Información del Instituto Nacional del Cáncer sobre el tratamiento del carcinoma de corteza suprarrenal, así como referencias a estudios clínicos, investigación y otros temas relacionados con este tipo de cáncer.

  17. Comparison of the effectiveness and renal safety of tenofovir versus entecavir in patients with chronic hepatitis B.

    PubMed

    López Centeno, Beatriz; Collado Borrell, Roberto; Pérez Encinas, Montserrat; Gutiérrez García, Maria Luisa; Sanmartin Fenollera, Patricia

    2016-06-01

    Objetivo: Comparar la efectividad y seguridad renal del tratamiento con tenofovir frente al entecavir en pacientes con hepatitis B cronica. Métodos: Estudio retrospectivo en pacientes con hepatitis B que iniciaron tratamiento con tenofovir o entecavir entre enero 1998-2013. La variable principal de la efectividad fue definida como DNA viral < 20 UI/ml (HBV-DNA) y la de la seguridad renal como variaciones en el filtrado glomerular (eGFR) tras 48 semanas de tratamiento. Resultados: Se analizaron un total de 64 pacientes (1:1), con caracteristicas semejantes excepto por el predominio de pacientes sin tratamiento previo (p=0,036), comorbilidades (p=0,077) y farmacos nefrotoxicos (p=0,088) en el grupo-entecavir, y de pacientes con HBV-DNA < 20 UI/ml (p=0,032) y HBeAg-positivo (p=0,050) en el grupo-tenofovir. Se realizaron analisis estadisticos univariantes y se ajustaron las variables confusoras mediante Propensity score (PS). Los resultados para la variable principal de efectividad (HBV-DNA < 20 UI/ml) denotan una superioridad del tenofovir tras el ajuste por PS con una ORadj= 6,7 (IC95%: 1,2-35,3; p=0,028). Tres pacientes con tenofovir sufrieron seroconversion (p=0,148). Los resultados para la variable principal de seguridad (eGFR < 60ml/min/1.73m2) no mostraron diferencias entre ambas ramas tras el ajuste, obteniendo una ORadj= 0,6 (IC95%: 0,1-2,8; p=0,521). El grupo-tenofovir registro dos casos de suspension por toxicidad renal, con posterior recuperacion, entre ellos un sindrome de Fanconi. Conclusiones: En nuestro estudio existen diferencias significativas entre ambos tratamientos respecto a su efectividad, mostrandose el tenofovir superior. En cuanto a la seguridad renal, no hemos encontrado diferencias significativas, pero dos casos de suspension de tratamiento por toxicidad renal con tenofovir nos llevan a concluir que la decision de tratamiento en los pacientes con alteraciones en la funcion renal deberia incluir un analisis individualizado de cada caso.

  18. [Pharmacological management of attention deficit hyperactivity disorder with methylphenidate and atomoxetine within a context of epilepsy].

    PubMed

    Mulas, Fernando; Roca, Patricia; Ros-Cervera, Gonzalo; Gandía-Benetó, Rubén; Ortiz-Sánchez, Pedro

    2014-02-24

    Introduccion. La prevalencia del trastorno por deficit de atencion/hiperactividad (TDAH) en pacientes con epilepsia se situa en torno al 30-40%, especialmente del subtipo inatento, mientras que, a su vez, distintos estudios sobre niños diagnosticados de TDAH muestran cifras variables del 6,1-30% que presentan alteraciones en el electroencefalograma y problemas de epilepsia. Aunque las guias de practica clinica no desaconsejan el tratamiento con psicoestimulantes en el TDAH comorbido con epilepsia, en especial si esta no se considera activa, algunos investigadores y clinicos recomiendan ser cautos en el inicio de esta terapia farmacologica, mientras que el uso de no psicoestimulantes esta menos estudiado. Objetivo. Revisar las historias clinicas de niños con epilepsia y TDAH que recibieron tratamiento farmacologico con psicoestimulantes y no psicoestimulantes para el trastorno de atencion. Pacientes y metodos. Muestra de 23 pacientes de 5-16 años. Se analizo el tipo de epilepsia y la evolucion clinica y electroencefalografica al año y a los dos años tras el inicio del tratamiento farmacologico del TDAH. Resultados. A los dos años, un paciente presento una crisis y dos pacientes continuaban mostrando actividad paroxistica en el electroencefalograma. Conclusion. Los datos presentados muestran que el tratamiento farmacologico del TDAH no empeora la epilepsia en pacientes bien controlados, aunque se recomienda tener en cuenta factores como el tipo de farmaco antiepileptico, el tipo de farmaco para el TDAH, asi como el perfil cognitivo, para favorecer un desarrollo adecuado. En los niños epilepticos con dificultades del aprendizaje, deben valorarse los mecanismos de los procesos atencionales que puedan estar alterados y que precisen un tratamiento especifico.

  19. [Pregnancy and myeloid leukemia treated with imatinib. Development and monitoring of a patient].

    PubMed

    Báez-de la Fuente, Enrique; Arellano-Severiano, Baltazar

    2014-01-01

    INTRODUCCIÓN: el tratamiento con imatinib ha modificado la historia natural de la leucemia mieloide crónica, y ha permitido que las mujeres con este padecimiento puedan embarazarse. El objetivo de este reporte es describir el curso y desenlace de un embarazo en una paciente con diagnóstico previo de leucemia mieloide crónica, que recibía tratamiento con imatinib. CASO CLÍNICO: mujer de 32 años con leucemia mieloide crónica de 11 años de evolución. Al diagnóstico se inició tratamiento estándar, pero debido a poca adherencia terapéutica, a los dos años se le prescribió imatinib. Debido al deseo de procrear, la paciente decidió suspender el medicamento. Un mes después acudió a la consulta con amenorrea de seis semanas de evolución; se confirmó embarazo. Durante 10 meses que permaneció sin tratamiento, no tuvo síntomas de progresión de la leucemia. El embarazo se interrumpió por cesárea a las 35.5 semanas de gestación. El neonato aparentemente se encontraba sano. En el transcurso del puerperio quirúrgico, la paciente acudió a consulta; los resultados de la biometría hemática indicaron hemoglobina de 8.7 g/dL, hematócrito de 25 %, leucocitos de 22 000/mL y plaquetas de 170 000/mL. Ese día se reinició tratamiento con 600 mg/día de imatinib.

  20. [Association between overweight, glucocorticoids and metabolic syndrome in cancer patients under chemotherapy].

    PubMed

    Sánchez-Lara, Karla; Hernández, Diego; Motola, Daniel; Green, Dan

    2013-01-01

    En pacientes con diagnostico de cáncer en tratamiento con quimioterapia es común encontrar componentes del síndrome metabólico (SM) como sobrepeso, obesidad, resistencia a la insulina e hiperglicemia. Estos componentes se han asociado a mayor recurrencia de la enfermedad. Objetivos: describir la relación entre el IMC, el uso de glucocorticoides y el sitio de tumor con los factores del SM en pacientes tratados con quimioterapia de un centro hospitalario universitario. Métodos: Estudio retrospectivo donde se revisaron expedientes de pacientes tratados en el centro oncológico del 2008 al 2010, con diagnóstico de cáncer y en tratamiento con quimioterapia sistémica. Se recopilo información acerca de datos antropométricos y criterios de SM definidos por ATP III. Resultados: Se incluyeron 158 pacientes, 75,9% genero femenino, los tumores mas comunes fueron mama, gastrointestinal y pulmón. Más de la mitad de los pacientes presentaron >3 componentes del SM (56,3%); El 43,6% de pacientes recibieron dexametasona como parte del tratamiento. El IMC promedio fue de 25,3 kg/m(2). El diagnostico de cáncer de mama en tratamiento con quimioterapia se asoció con la presencia de 3 o más componentes del SM. La administración de glucocorticoides no se asoció a la presencia de SM. Conclusiones: los sujetos con IMC>25 tienen 12,6 veces más el riesgo de padecer SM, independientemente del uso de glucocorticoides en el tratamiento. El mantenimiento de un peso adecuado en el paciente oncológico es importante para reducir los factores de riesgo del SM.

  1. [Fingolimod: effectiveness and safety in routine clinical practice. An observational, retrospective, multi-centre study in Navarra, Gipuzkoa and La Rioja].

    PubMed

    Ayuso, T; Marzo-Sola, M E; Castillo-Trivino, T; Soriano, G; Otano, M A; Lopez, M A; Croitoru, I M; Olascoaga, J

    2016-09-01

    Objetivo. Evaluar la efectividad y seguridad del fingolimod en la practica clinica en las regiones de Navarra, Gipuzkoa y La Rioja. Pacientes y metodos. Estudio retrospectivo y multicentrico de pacientes con esclerosis multiple recurrente tratados con fingolimod, siguiendo la ficha tecnica. Se evaluo la tasa anualizada de brotes (TAB), el porcentaje de pacientes libres de brotes, la discapacidad usando la escala expandida del estado de discapacidad (EDSS) y el porcentaje de pacientes sin lesiones captantes de gadolinio. Resultados. Un total de 113 pacientes fueron tratados con fingolimod: el 6%, naive, y el 58% y 35%, pacientes tratados previamente con inmunomodulador y natalizumab, respectivamente. El fingolimod disminuyo la TAB tras el primer (67%; 1 a 0,3; p < 0,0001) y segundo (89%; 1 a 0,1; p < 0,0001) año de tratamiento, y aumento asi el porcentaje de pacientes libres de brotes durante el tratamiento. La EDSS basal fue 3 y despues del tratamiento con fingolimod fue 2,5 en ambos años. El porcentaje de pacientes sin lesiones captantes de gadolinio tras el primer año de tratamiento fue del 77%. Resultados similares se observaron en los pacientes naive y en los tratados previamente con inmunomodulador. En los pacientes tratados previamente con natalizumab no se observaron cambios tras el tratamiento. Conclusiones. El uso del fingolimod en la practica clinica mostro una efectividad similar a la eficacia observada en ensayos clinicos. No hubo cambios en la TAB al cambiar desde natalizumab, y solo un paciente tras suspender el natalizumab presento 'rebrote'. El fingolimod se comporta como un farmaco seguro, con escasos efectos adversos y con un bajo porcentaje de abandonos.

  2. [Study on the usage, effectiveness, and toxicity associated to treatment with sorafenib].

    PubMed

    Camañas-Troyano, C; Moriel-Sánchez, Ma; Catalá-Pizarro, R Ma

    2013-01-01

    Objetivo: Conocer la utilización, efectividad y toxicidad asociada al tratamiento con sorafenib en los pacientes oncológicos de un hospital general. Métodos: Estudio observacional, retrospectivo y longitudinal de utilización, efectividad y toxicidad asociada a sorafenib. Se incluyeron los pacientes oncológicos de un hospital general universitario, que iniciaron tratamiento con sorafenib entre Enero 2007 y Diciembre 2010, ampliando el periodo de seguimiento hasta junio de 2012. Resultados: Iniciaron tratamiento 31 pacientes (edad media 61,6 años, 67,7% varones). En todos se utilizó un régimen de monoterapia, empleándose dosis fijas de 400 mg cada 12 horas en el 83,87%, mientras que 5 pacientes precisaron ajuste de dosis por mala tolerancia gastrointestinal y toxicidad cutánea. Al finalizar el estudio, 3 pacientes continuaban vivos y mantuvieron el tratamiento, 27 pacientes lo suspendieron y en 1 paciente se perdió el seguimiento. Las patologías tratadas con sorafenib fueron hepatocarcinoma (38,7%), cáncer renal avanzado (35,5%), melanoma (9,7%), caeacute;ncer de tiroides (12,9%) y tumor del estroma gastrointestinal (3,2%). La mediana de supervivencia global fue de 524 días para hepatocarcinoma y de 217 días para cáncer renal. Se observaron reacciones adversas a sorafenib en el 41,9% de los pacientes. Conclusiones: Este estudio revela que sorafenib es eficaz en los pacientes con hepatocarcinoma y cáncer renal, dependiendo fundamentalmente de la situación clínica inicial de los pacientes. Sorafenib es responsable de la aparición de efectos secundarios, fundamentalmente de tipo gastrointestinal y cutáneo, que requirieron ajuste de dosis y suspensión del tratamiento en algunos casos.

  3. [OBESITY MANAGEMENT IN THE PRIMARY CARE SETTING BY AN INTENSIVE LIFESTYLE INTERVENTION].

    PubMed

    Armenta Guirado, Brianda Ioanna; Díaz Zavala, Rolando Giovanni; Valencia Juillerat, Mauro Eduardo Fernando; Quizán Plata, Trinidad

    2015-10-01

    Objetivo: comparar un Programa Intensivo de Cambio de Estilo de Vida con el Tratamiento Tradicional para el manejo de la obesidad en el primer nivel de atención. Sujetos y métodos: estudio de intervención aleatorizado controlado, en el que participaron 42 adultos con obesidad. Los sujetos asignados al Programa Intensivo de Cambio de Estilo de Vida recibieron un protocolo de cambio de conducta validado “Equilibrio de Estilo de Vida” en 12 sesiones, consultas semanales con un nutriólogo y remplazos de comidas. El Tratamiento Tradicional consistió en consultas mensuales con un nutriólogo que proporcionó orientación nutricional y de actividad física. Resultados: después de tres meses se midió al 97% de los participantes que iniciaron el estudio. Los sujetos del Programa Intensivo de Cambio de Estilo de Vida y del Tratamiento Tradicional mostraron los siguientes cambios en el peso corporal: (mediana [percentil 25-75]) (-4,7 kg [-6,5, -3,1]) vs. (+0,4 kg [-0,3, 1,3]). El 62% de los participantes del Programa Intensivo de Cambio de Estilo de Vida bajaron más de un 5% del peso corporal, contra el 0% en el grupo de Tratamiento Tradicional (p < 0,001). Conclusiones: este estudio es una evidencia preliminar de que un Programa Intensivo de Cambio de Estilo de Vida puede ser una alternativa efectiva para el tratamiento de la obesidad en el primer nivel de atención.

  4. [Persistence in drug therapy of hypertension among different treatment groups and comparison between fixed-dose combinations of ara II + calcium channel blockers vs ace inhibitors + calcium channel blockers].

    PubMed

    Waisman, Gabriel Dario; Garfi, Leonardo Guillermo; Izbizky, Gustavo Hernan; Tortella, Juan Jose

    2012-01-01

    La hipertensión arterial (HTA) es una enfermedad crónica, y prevalente, que requiere un tratamiento sostenido en el tiempo donde existen medidas farmacológicas y no farmacológicas para su control. La “persistencia” es la continuidad de los tratamientos farmacológicos. Conocer cual es la persistencia de los diferentes grupos terapéuticos antihipertensivos podría ayudar a priorizar aquellos con mejores resultados. El objetivo es describir la persistencia al tratamiento antihipertensivo en una cohorte de pacientes utilizando diferentes métodos y comparar la persistencia en los diferentes grupos farmacológicos utilizados para el tratamiento de la HTA. Materiales y Métodos: Estudio observacional, de cohorte retrospectiva utilizando bases de datos secundarias obtenidas durante la dispensación de medicamentos y de los registros hospitalarios electrónicos del Hospital Italiano de Buenos Aires. Población adulta con diagnóstico de HTA y seguimiento por 2 años. Resultados: Los diuréticos, betabloqueantes de primera generación e inhibidores de la enzima convertidora de angiotensina son los grupos con la caída más importante en la persistencia. Los antagonistas de la angiotensina en monoterapia o junto con diurético y los betabloqueantes de segunda generación demostraron los mejores resultados de persistencia. La persistencia nunca llegó al 60% de los pacientes tratados a los 2 años. Conclusión: Pese a haber realizado la medición de la persistencia a través de distintos métodos los resultados fueron similares y demostraron una baja persistencia al tratamiento antihipertensivo. No encontramos variables extra farmacológicas que pudieran explicar la diferente persistencia en los diferentes grupos terapéuticos.

  5. [Cost-effectiveness of buccal midazolam in the treatment of prolonged convulsive seizures in the outpatient setting in Spain].

    PubMed

    Raspall-Chaure, Miquel; Martinez-Bermejo, Antonio; Sanchez-Carpintero, Rocío; Ruiz-Falco Rojas, M Luz; Verdu-Perez, Alfonso; Smeyers-Dura, Patricia; Camino-Leon, Rafael; Sanmarti, Francesc X; Santos-Borbujo, José; Pico, Gustavo; Blanco-Barca, Oscar; Cebollero, M Antonia

    2014-06-01

    Introduccion. El tratamiento de las crisis epilepticas prolongadas requiere disponer de una medicacion de rescate comoda, segura y efectiva. Actualmente, el tratamiento estandar en la comunidad es el diacepam rectal. La introduccion de una solucion bucal de midazolam abre una perspectiva nueva en el tratamiento. Objetivo. Evaluar el coste-efectividad del midazolam bucal respecto al diacepam rectal para los niños con un diagnostico de epilepsia que presentan crisis convulsivas prolongadas en la comunidad en España. Materiales y metodos. Modelo coste-efectividad desde la perspectiva del Sistema Nacional de Salud (SNS) español, con resultados presentados en terminos de costes y años de vida ajustados por calidad. Los datos se obtuvieron de varias fuentes, incluidas las estimaciones de efectividad clinica de un ensayo clinico, de un panel Delphi en España y de una encuesta nacional a padres de niños con epilepsia para determinar las practicas actuales. Resultados. El tratamiento con midazolam bucal produce un ahorro de costes en comparacion con el diacepam rectal. El ahorro para el SNS español es de 5.484 euros por paciente al año. El tratamiento con midazolam bucal ofrece una mejora en la calidad de vida relacionada con la salud. Esto, unido al ahorro de costes, hace que el midazolam bucal sea dominante frente al diacepam rectal en todos los escenarios examinados. Conclusion. Los resultados del modelo muestran que el midazolam bucal es mas coste-efectivo que el diacepam rectal debido a una reduccion en la necesidad de llamadas a la ambulancia y estancias en el hospital, asi como a una mejora en la calidad de vida relacionada con la salud.

  6. [Usefulness of electronic drug registers: Spanish register of patients treated with fingolimod (Gilenya ®)].

    PubMed

    Fernández, Óscar; Rodríguez-Antigüedad, Alfredo; Oreja-Guevara, Celia; Garcia-Garcia, Margarida; Montalban, Xavier

    2014-01-16

    Introduccion. Se describe el diseño de un registro electronico de los pacientes con esclerosis multiple que inician tratamiento con fingolimod en España, que se plantea como una herramienta para monitorizar su manejo en la practica clinica habitual que permita optimizar su uso. Objetivos. Conocer el perfil de los pacientes con esclerosis multiple en tratamiento con fingolimod y determinar la efectividad y seguridad de este tratamiento en la practica clinica habitual. Desarrollo. Se establece un registro observacional, retrospectivo y prospectivo, multicentrico, que estara activo durante cinco años. Participaran 40 neurologos de España. Se incluiran pacientes tratados con fingolimod que cumplan los criterios de seleccion. Las variables de efectividad que se evaluaran son: la discapacidad medida mediante la escala ampliada del estado de discapacidad, la tasa de brotes, las lesiones captantes de gadolinio en secuencia T1 y las lesiones nuevas en secuencia T2, y el porcentaje de pacientes libres de actividad y aquellos que requieran tratamientos concomitantes. Las variables de seguridad que se evaluaran son: la tasa de pacientes que presenten acontecimientos y reacciones adversas, respectivamente, analizandose separadamente aquellos que se presenten tras la primera dosis o relacionados con el plan de manejo del riesgo de fingolimod, y la tasa de abandonos del tratamiento. Conclusiones. Los nuevos farmacos de reciente comercializacion requieren mayor informacion acerca de su efectividad y seguridad, mas alla del entorno controlado de un ensayo clinico. Las iniciativas de registros electronicos como el registro Gilenya son la solucion para dar respuesta a dicha necesidad, proporcionando informacion en el menor tiempo posible acerca del manejo mas adecuado para conseguir su uso mas optimo y eficiente posible.

  7. [What is the optimal dose for the prophylactic treatment of chronic migraine patients?].

    PubMed

    Irimia, Pablo; Esteve-Belloch, Patricia; Murie-Fernandez, Manuel; Martinez-Vila, Eduardo

    2014-03-10

    Introduccion. La OnabotulinumtoxinA (OnabotA) esta indicada para el tratamiento preventivo de los pacientes con diagnostico de migraña cronica. Existe cierta controversia acerca de cual es la dosis minima eficaz de OnabotA. Objetivo. Determinar cual es la dosis mas adecuada de OnabotA para el tratamiento de la migraña cronica. Desarrollo. Se revisan los estudios controlados frente a placebo, que han evaluado la eficacia y seguridad de OnabotA para el tratamiento de la migraña, prestando especial atencion a las dosis de toxina utilizadas. En los diferentes ensayos clinicos llevados a cabo antes del año 2010 se utilizaron distintos protocolos de infiltracion. La experiencia obtenida de los estudios previos permitio definir un protocolo de infiltracion que se utilizo en el programa PREEMPT, y que demostro que el tratamiento con OnabotA es seguro y eficaz en pacientes con migraña cronica. La dosis elegida en los ensayos PREEMPT 1 y 2 fue de 155-195 U, al observarse en los estudios en fase II que la dosis de 75 U no era eficaz y que la utilizacion de 150-200 U aumentaba la eficacia sin incrementar los efectos adversos. Ademas de la dosis, el paradigma de inyeccion PREEMPT tambien establece de manera detallada los puntos de inyeccion y la metodologia de infiltracion. Conclusiones. La evidencia cientifica disponible hasta la fecha sustenta que la dosis mas adecuada para el tratamiento de la migraña cronica es la utilizacion de al menos 150 U de OnabotA, y que la infiltracion debe realizarse con la metodologia definida en el paradigma de inyeccion PREEMPT.

  8. [Lacosamide and neuropathic pain, a review].

    PubMed

    Alcántara-Montero, Antonio; Sánchez-Carnerero, Clara I

    2016-03-01

    Introduccion. La mayor parte de las guias de practica clinica consultadas coinciden en señalar que los antidepresivos triciclicos, duales (venlafaxina/duloxetina), antiepilepticos gabapentina/pregabalina, apositos de lidocaina al 5% y parches de capsaicina al 8% constituyen los farmacos de primera linea en el tratamiento del dolor neuropatico periferico, y el tramadol y algunos opioides potentes (morfina, oxicodona y tapentadol) son farmacos de segunda linea. Por otra parte, la prevalencia de dolor neuropatico refractario al tratamiento se acerca al 1,5% de la poblacion, de forma que se calcula que un 50% de los pacientes no responde al tratamiento prescrito. Existen otros antiepilepticos que no tienen indicacion en el dolor neuropatico por las agencias reguladoras, como la lamotrigina, el topiramato o la oxcarbacepina, pero se utilizan en la practica clinica habitual fuera de indicacion. Desarrollo. Tras una busqueda bibliografica, se realizo una revision sobre el empleo de la lacosamida en el dolor neuropatico, tanto en distintos modelos animales como en diferentes estudios en humanos. Conclusiones. El tratamiento con lacosamida en el dolor neuropatico de diferentes etiologias podria considerarse como una alternativa efectiva para los pacientes que no respondan o no toleren los tratamientos estandares. Sin embargo, la mayor parte de la evidencia disponible, a excepcion de los ensayos clinicos en fase II/III realizados en el dolor neuropatico diabetico, corresponde a estudios abiertos y observacionales, sin grupo control y con bajo numero de pacientes, pero los resultados favorables obtenidos invitan a seguir investigando la utilidad de la lacosamida en el dolor neuropatico.

  9. [Postmastectomy pain syndrome in our region: characteristics, treatment, and experience with gabapentin].

    PubMed

    de Miguel-Jimeno, Juan M; Forner-Cordero, Isabel; Zabalza-Azparren, Marta; Matute-Tobias, Belinda

    2016-03-16

    Introduccion. El sindrome de dolor posmastectomia puede afectar a mas de la mitad de pacientes intervenidas por cancer de mama. Objetivos. Revisar las caracteristicas clinicas de este sindrome y su evolucion, y evaluar la respuesta al tratamiento farmacologico. Pacientes y metodos. Estudio retrospectivo de 65 pacientes con un seguimiento superior a cinco años. Resultados. El 88% de las pacientes estaba sin diagnosticar. Su edad media era de 56,49 años y permanecieron con dolor un promedio de 29,15 meses. En el 71%, las alteraciones neurologicas correspondieron al segundo nervio intercostobraquial. La media en la puntuacion de dolor antes del tratamiento fue de 66,5 puntos en la escala analogica visual y de 13,14 en el indice de Lattinen. El tratamiento con gabapentina (dosis media: 1.135 mg/dia; duracion media: 14 semanas) disminuyo el dolor en el 80% de las pacientes (p < 0,0001). La mejoria se mantuvo a largo plazo. Un 10% continuo en tratamiento y el 10% debio suspenderlo por efectos secundarios. El numero necesario de pacientes que hubo que tratar fue de 2,13. Recidivo el 35% y preciso cambiar de farmaco el 15,68% de las tratadas con gabapentina, frente al 50% de las tratadas con otros farmacos (p = 0,046). No se encontraron diferencias en la eficacia entre ambos grupos. Conclusiones. El dolor posmastectomia es una patologia infradiagnosticada. El tratamiento (en especial con gabapentina) puede ser eficaz y bien tolerado hasta en el 90% de las pacientes de forma significativa.

  10. Accuracy and Reproducibility of Right Ventricular Quantification in Patients with Pressure and Volume Overload Using Single-Beat Three-Dimensional Echocardiography

    PubMed Central

    Knight, Daniel S.; Grasso, Agata E.; Quail, Michael A.; Muthurangu, Vivek; Taylor, Andrew M.; Toumpanakis, Christos; Caplin, Martyn E.; Coghlan, J. Gerry; Davar, Joseph

    2015-01-01

    Background The right ventricle is a complex structure that is challenging to quantify by two-dimensional (2D) echocardiography. Unlike disk summation three-dimensional (3D) echocardiography (3DE), single-beat 3DE can acquire large volumes at high volume rates in one cardiac cycle, avoiding stitching artifacts or long breath-holds. The aim of this study was to assess the accuracy and test-retest reproducibility of single-beat 3DE for quantifying right ventricular (RV) volumes in adult populations of acquired RV pressure or volume overload, namely, pulmonary hypertension (PH) and carcinoid heart disease, respectively. Three-dimensional and 2D echocardiographic indices were also compared for identifying RV dysfunction in PH. Methods A prospective cross-sectional study was performed in 100 individuals who underwent 2D echocardiography, 3DE, and cardiac magnetic resonance imaging: 49 patients with PH, 20 with carcinoid heart disease, 11 with metastatic carcinoid tumors without cardiac involvement, and 20 healthy volunteers. Two operators performed test-retest acquisition and postprocessing for inter- and intraobserver reproducibility in 20 subjects. Results: RV single-beat 3DE was attainable in 96% of cases, with mean volume rates of 32 to 45 volumes/sec. Bland-Altman analysis of all subjects (presented as mean bias ± 95% limits of agreement) revealed good agreement for end-diastolic volume (−2.3 ± 27.4 mL) and end-systolic volume (5.2 ± 19.0 mL) measured by 3DE and cardiac magnetic resonance imaging, with a tendency to underestimate stroke volume (−7.5 ± 23.6 mL) and ejection fraction (−4.6 ± 13.8%) by 3DE. Subgroup analysis demonstrated a greater bias for volumetric underestimation, particularly in healthy volunteers (end-diastolic volume, −11.9 ± 18.0 mL; stroke volume, −11.2 ± 20.2 mL). Receiver operating characteristic curve analysis showed that 3DE-derived ejection fraction was significantly superior to 2D echocardiographic

  11. Interleukin-12 and Trastuzumab in Treating Patients With Cancer That Has High Levels of HER2/Neu

    ClinicalTrials.gov

    2013-02-27

    Advanced Adult Primary Liver Cancer; Anaplastic Thyroid Cancer; Bone Metastases; Carcinoma of the Appendix; Distal Urethral Cancer; Fallopian Tube Cancer; Gastrinoma; Glucagonoma; Inflammatory Breast Cancer; Insulinoma; Liver Metastases; Localized Unresectable Adult Primary Liver Cancer; Lung Metastases; Male Breast Cancer; Malignant Pericardial Effusion; Malignant Pleural Effusion; Metastatic Gastrointestinal Carcinoid Tumor; Metastatic Parathyroid Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Newly Diagnosed Carcinoma of Unknown Primary; Occult Non-small Cell Lung Cancer; Pancreatic Polypeptide Tumor; Primary Peritoneal Cavity Cancer; Proximal Urethral Cancer; Pulmonary Carcinoid Tumor; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Adrenocortical Carcinoma; Recurrent Adult Primary Liver Cancer; Recurrent Anal Cancer; Recurrent Bladder Cancer; Recurrent Breast Cancer; Recurrent Carcinoma of Unknown Primary; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Endometrial Carcinoma; Recurrent Esophageal Cancer; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Recurrent Gastric Cancer; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Islet Cell Carcinoma; Recurrent Malignant Testicular Germ Cell Tumor; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Non-small Cell Lung Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Pancreatic Cancer; Recurrent Parathyroid Cancer; Recurrent Prostate Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Salivary Gland Cancer; Recurrent Small Intestine Cancer; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Thyroid Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Recurrent Vaginal

  12. Erlotinib Hydrochloride and Cetuximab in Treating Patients With Advanced Gastrointestinal Cancer, Head and Neck Cancer, Non-Small Cell Lung Cancer, or Colorectal Cancer

    ClinicalTrials.gov

    2015-09-28

    Adenocarcinoma of the Colon; Adenocarcinoma of the Rectum; Advanced Adult Primary Liver Cancer; Carcinoma of the Appendix; Gastrointestinal Stromal Tumor; Metastatic Gastrointestinal Carcinoid Tumor; Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Adult Primary Liver Cancer; Recurrent Anal Cancer; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Colon Cancer; Recurrent Esophageal Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Recurrent Gastric Cancer; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Non-small Cell Lung Cancer; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Salivary Gland Cancer; Recurrent Small Intestine Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Small Intestine Adenocarcinoma; Small Intestine Leiomyosarcoma; Small Intestine Lymphoma; Stage IV Adenoid Cystic Carcinoma of the Oral Cavity; Stage IV Anal Cancer; Stage IV Basal Cell Carcinoma of the Lip; Stage IV Colon Cancer; Stage IV Esophageal Cancer; Stage IV Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage IV Gastric Cancer

  13. Identity and pathogenesis of stomach tumors in Sprague-Dawley rats associated with the dietary administration of butachlor.

    PubMed

    Hard, G C; Iatropoulos, M J; Thake, D C; Wheeler, D; Tatematsu, M; Hagiwara, A; Williams, G M; Wilson, A G

    1995-05-01

    Macroscopic stomach tumors induced in Sprague-Dawley rats during two chronic bioassays with the acetanilide herbicide butachlor at a dietary concentration of 3000 ppm, were evaluated histologically and immunohistochemically in order to determine their identity and pathogenesis. The tumors, which occurred primarily in female rats, were a heterogeneous series, including a few consisting wholly or partly of classic solid or anaplastic epithelium, but with the majority containing diffusely distributed primitive neoplastic cells. The latter had either the general appearance of undifferentiated epithelium or presented a more "mesenchyme-like" pattern where the cells were epithelioid, blastema-like, neuroendocrine-like or sarcoma-like with fascicular disposition. Gastric glandular profiles were also present, usually located near the periphery of the tumors, but in some cases extending into the diffuse tumor tissue. Most of the tumors displayed variable immunohistochemical reactivity for cytokeratin, vimentin and neuron-specific enolase but were negative for muscle-specific actin or desmin except in the stromal tracts. Detailed examination of all available gastric tissue revealed the presence of additional microscopic neoplasms and precursor hyperplastic lesions. All of these were typical gastric neuroendocrine cell lesions (gastric carcinoids) originating in the fundic mucosa but occasionally invading submucosally, and consisting of epithelial cells in organized clusters, rosettes or primitive tubules. The enterochromaffin-like (ECL) nature of these microscopic neoplasms and precursor lesions was substantiated by strong immunohistochemical reactivity for cytokeratin, neuron-specific enolase and chromogranin A, and a negative reaction for vimentin. One microscopic tumor showed a transition from differentiated neuroendocrine type in the fundic mucosa to a dispersed "mesenchyme-like" pattern in the submucosal extension. An additional finding in the butachlor-treated male and

  14. Phenotypic heterogeneity studied by immunohistochemistry and aneuploidy in non-small cell lung cancers.

    PubMed

    Pujol, J L; Simony, J; Laurent, J C; Richer, G; Mary, H; Bousquet, J; Godard, P; Michel, F B

    1989-05-15

    Non-small cell lung cancers (non-SCLC) differ from small cell lung cancers (SCLC) by many clinical features and prognosis. However, recent studies suggest that lung cancer heterogeneity frequently leads to the association of SCLC and non-SCLC in the same tumor. This phenotypic heterogeneity can be analyzed by immunohistochemistry using monoclonal antibodies (Mab) raised against differentiation related antigens. It may have clinical relevance inasmuch as the diversification of malignant cells is a well-known factor of tumor progression and may be due to chromosomal instability because inappropriate gene expression leads to the formation of antigens unrelated to cell lineage. Chromosomal instability in cancer leads to aneuploidy detectable by cell DNA content analysis. In a prospective study, we analyzed, in parallel, the expression of neuroendocrine related antigens by immunohistochemistry and the cell DNA content in frozen specimens from 40 patients who underwent complete surgical resection of primary non-SCLC in an attempt (a) to characterize the phenotypic heterogeneity and (b) to determine whether this heterogeneity is correlated with aneuploidy and clinical staging. Three Mabs were used in association as a marker of neuroendocrine antigen expression (S-L 11.14, MOC-1, and NE-25); reactivity of these Mabs in 9 SCLC and 3 lung carcinoid tissue sections was used as positive control. All SCLC and 2 of 3 lung carcinoids tested were homogeneously positive with Mabs S-L 11.14, MOC-1, and NE-25; 13 of 40 non-SCLC were homogeneously positive and 11 additional specimens focally positive with Mabs S-L 11.14, MOC-1, and NE-25. The frequency of this abnormal phenotype was significantly higher in poorly differentiated squamous cell carcinomas (chi 2 10.08; P less than 0.005), in clinical stage III non-SCLC (chi 2 5.93; P less than 0.02), and in tumors involving mediastinal lymph nodes (chi 2 5; P less than 0.03). The percentage of cells in the modal DNA of G0-G1 phase was

  15. High-level microsatellite instability in appendiceal carcinomas.

    PubMed

    Taggart, Melissa W; Galbincea, John; Mansfield, Paul F; Fournier, Keith F; Royal, Richard E; Overman, Michael J; Rashid, Asif; Abraham, Susan C

    2013-08-01

    High-level microsatellite instability (MSI-high) is found in approximately 15% of all colorectal adenocarcinomas (CRCs) and in at least 20% of right-sided cancers. It is most commonly due to somatic hypermethylation of the MLH1 gene promoter region, with familial cases (Lynch syndrome) representing only 2% to 3% of CRCs overall. In contrast to CRC, MSI-high in appendiceal adenocarcinomas is rare. Only 4 MSI-high appendiceal carcinomas and 1 MSI-high appendiceal serrated adenoma have been previously reported, and the prevalence of MSI in the appendix is unknown. We identified 108 appendiceal carcinomas from MD Anderson Cancer Center in which MSI status had been assessed by immunohistochemistry for the DNA mismatch-repair proteins MLH1, MSH2, MSH6, and PMS2 (n=83), polymerase chain reaction (n=7), or both (n=18). Three cases (2.8%) were MSI-high, and 1 was MSI-low. The 3 MSI-high cases included: (1) a poorly differentiated nonmucinous adenocarcinoma with loss of MLH1/PMS2 expression, lack of MLH1 promoter methylation, and lack of BRAF gene mutation, but no detected germline mutation in MLH1 from a 39-year-old man; (2) an undifferentiated carcinoma with loss of MSH2/MSH6, but no detected germline mutation in MSH2 or TACSTD1, from a 59-year-old woman; and (3) a moderately differentiated mucinous adenocarcinoma arising in a villous adenoma with loss of MSH2/MSH6 expression, in a 38-year-old man with a strong family history of CRC who declined germline testing. When the overall group of appendiceal carcinomas was classified according to histologic features and precursor lesions, the frequencies of MSI-high were: 3 of 108 (2.8%) invasive carcinomas, 3 of 96 (3.1%) invasive carcinomas that did not arise from a background of goblet cell carcinoid tumors, and 0 of 12 (0%) signet ring and mucinous carcinomas arising in goblet cell carcinoid tumors. These findings, in conjunction with the previously reported MSI-high appendiceal carcinomas, highlight the low prevalence of MSI

  16. [Use of leflunomide in a cytomegalovirus infection resistant: a report of a case].

    PubMed

    Gómez Valbuena, Isabel; Alioto, Daniel; Serrano Garrote, Olga; Ferrari Piquero, Jose Miguel

    2016-01-01

    Introducción: la infección por citomegalovirus (CMV) es una de las complicaciones más habituales en pacientes trasplantados, que puede desembocar en un fallo multiorgánico. El 80-90% de los pacientes se cura con el tratamiento estándar intravenoso (ganciclovir), o su profármaco oral (valganciclovir). En caso de no responder a ellos existe como alternativa otro antivírico, foscarnet. Un pequeño número de pacientes tampoco responden a este, teniendo un mal pronóstico. Objetivo: describir el caso de una paciente con trasplante bipulmonar por fibrosis quística y recidiva de infección por CMV en la cual el uso de leflunomida consigue disminuir e incluso llegar a niveles indetectables de la carga viral. Descripción del caso: mujer de 22 años, trasplantada bipulmonar por fibrosis quística en marzo del 2014. Las serologías de CMV realizadas fueron positivas en el donante y negativas en el receptor. Los controles de la carga viral durante la profilaxis con valganciclovir fueron negativos en el receptor hasta el sexto mes después del trasplante, momento en el que se detectó carga viral en los controles (2.090 UI/ml). La paciente ingresó en nuestro hospital para recibir tratamiento intravenoso con ganciclovir, persistiendo la carga viral positiva (42.400 UI/ml) al mes del inicio con esta terapia intravenosa. Un estudio de resistencias mostró que era resistente a ganciclovir, y por ello se inició tratamiento con foscarnet intravenoso. Con este fármaco se consiguió negativizar la carga viral, por lo que se suspendió el tratamiento, continuándose con controles quincenales de la carga viral. A los dos meses sin tratamiento se observó un aumento de la carga viral hasta 13.665 UI/ml, motivo por el cual se solicitó al Servicio de Farmacia el uso fuera de ficha técnica de leflunomida, con la intención de que la paciente recibiera terapia oral en lugar de intravenosa. La paciente fue tratada con valganciclovir hasta disponer de la autorización de uso de

  17. [Quality of the diet "before and during" a weight loss treatment based on Mediterranean Diet; behavioural therapy and nutritional education].

    PubMed

    Morales-Falo, Eva María; Sánchez-Moreno, Carmen; Esteban, Alberto; Alburquerque, Juan José; Garaulet, Marta

    2013-01-01

    Introducción: El método de pérdida de peso (dieta mediterránea, terapia de comportamiento y educación nutricional) ha mostrado ser efectivo en el tratamiento de la obesidad. Objetivo: El objetivo del presente trabajo es evaluar y comparar la calidad de las dietas ingeridas antes y durante el tratamiento mediante el Índice de Alimentación Saludable (IAS) y su relación con diferentes variables. Materiales y métodos: La muestra fue de 392 pacientes (330 mujeres, 62 hombres), edad 39,3 ± 11,5 años y IMC de 31,2 ± 5,3 kg/m2. A partir del recuerdo-24 h previo al tratamiento y del registro dietético 7 días se estimó el IAS de “antes” y “durante” tratamiento. El IAS consta de 10 variables que representan el cumplimiento de objetivos nutricionales para la población española (SENC, 2004). Resultados: Dieta previa, presentó un IAS “necesita mejorar” (68,6 ± 11,6) con lípidos (%) (43,9 ± 8,4) y AGS (% lípidos) (67,4 ± 20,1) elevados, además el contenido en AGM (% lípidos) (27,8 ± 15,1) fue insuficiente. El IAS varió en función del IMC siendo el de obesos inferior al de personas con sobrepeso (65,1 ± 11,6 vs 69, 2 ± 13,9; P < 0,05). La dieta ingerida durante el tratamiento mejoró notablemente IAS (91,4 ± 9,7). El IAS de las mujeres fue superior (92,3 ± 9,1) al de los hombres (84,4 ± 12,0) (P < 0,05). Aquellos que alcanzaron la meta de pérdida de peso adquirieron mejores valores de IAS durante el tratamiento que los que no la alcanzaron (92,1 ± 9,2 vs 87,9 ± 11,7) (P < 0,05). Conclusiones: Según el IAS, la calidad de la dieta estudiada durante el tratamiento de pérdida de peso mejoró significativamente en relación a la dieta habitual del paciente. El IAS de la dieta durante el tratamiento se asocia con el sexo, el estado ponderal (sobrepeso y obesidad) y con el éxito del tratamiento (> 5% de pérdida del peso inicial).

  18. [DIETARY INTAKE AND NUTRITIONAL STATUS IN ONCOLOGY PATIENTS WHO START TREATMENT WITH TYROSINE KINASE INHIBITORS].

    PubMed

    Higuera-Pulgar, Isabel; Ribed, Almudena; Carrascal-Fabian, M Luisa; Bretón-Lesmes, Irene; Romero-Jiménez, Rosa M; Cuerda-Compes, Cristina; Velasco-Gimeno, Cristina; Camblor-Álvarez, Miguel; García-Peris, Pilar

    2015-09-01

    Introducción: la investigación sobre nuevos antineoplásicos orales sigue avanzando en los últimos años mientras que su repercusión sobre la ingesta dietética y el estado nutricional (EN) no progresa de la misma forma. Objetivos: evaluar la ingesta dietética y EN de pacientes que inician tratamiento con inhibidores tirosina quinasa (ITK) y valorar el impacto que tienen sobre ellos. Métodos: estudio observacional y prospectivo de seis meses en el que se incluyeron pacientes que iniciaban tratamiento con ITK. La ingesta se evaluó con: recuerdo 24 h y cuestionario de frecuencia de consumo. El EN se valoró con: medidas antropométricas y cuestionario de valoración subjetiva global generada por el paciente (VSGGP); los resultados se compararon con las referencias SENC-semFYC, 2007 y Moreiras O., 2013. Para el análisis estadístico se utilizaron: Test de Friedman, 2, Wilcoxon, Kruskall-Wallis y Mann-Whitney. Significación p < 0,05. Resultados: se incluyeron 22 pacientes (54,5% hombres). Al inicio del tratamiento, el 73,9% tenía un EN adecuado según VSG-GP. No se produjeron pérdidas de peso significativas, pese a que un porcentaje elevado no cubrió los requerimientos energéticos y proteicos. El número de comidas se relacionó positivamente con la ingesta calórica. La ingesta y los patrones de frecuencia de consumo por grupos de alimentos tampoco variaron durante el tratamiento. Conclusión: la ingesta dietética al inicio del tratamiento no alcanza los requerimientos nutricionales. Los ITK no parecen afectar la ingesta ni el estado nutricional de los pacientes. El estudio de estos parámetros antes de comenzar el tratamiento evitaría futuras complicaciones y guiaría el consejo dietético.

  19. [Retrospective analysis of omalizumab in patients with severe allergic asthma].

    PubMed

    Padullés Zamora, Núria; Comas Sugrañes, Dolors; Méndez Cabaleiro, Nadia; Figueras Suriol, Anna; Jodar Masanes, Ramon

    2013-01-01

    Objetivo: Evaluar la eficacia y seguridad del omalizumab. Las condiciones para la administración de dicho fármaco fueron las indicadas en ficha técnica: edad superior a 12 años, asma alérgica grave persistente, mal control de síntomas, FEV1<80%, IgE total entre 30 y 700 UI/mL y pruebas cutáneas y/o IgE específica positiva al alérgeno persistente. Método: Estudio retrospectivo observacional de pacientes que hubieran sido tratados con omalizumab en la indicación de asma grave durante el período enero 2010 a julio de 2011. Se registraron la edad, sexo, peso, IgE y reactividad in vitro a los alergenos perennes, FEV1, tratamiento de base, exacerbaciones asmáticas y necesidad de corticosteroides sistémicos o ingresos en urgencias, presencia de síntomas durante el día o que originen despertares durante la noche al inicio del tratamiento, a las 16 semanas, 32 semanas y a los 1,5 años tras al inicio del tratamiento. Se recogieron los efectos secundarios y los cambios en el tratamiento de base. Resultados: 22 pacientes con un peso medio de 73 kg (51-102). La concentración basal de IgE antes del inicio de omalizumab fue de 203 UI/ml (30-992). 21 pacientes presentaban una función pulmonar reducida, con un FEV1 al inicio del 60% (30-93%). El FEV1 a las 16 semanas fue del 60% (39-71%) y a las 32 semanas del 68% (29-102%). La dosis media de omalizumab administrada cada 30 días fue de 368 mg (150- 900 mg). Se observaron reacciones adversas en 4 pacientes, uno de los cuales requirió la retirada del tratamiento. Al final del periodo de seguimiento 14 pacientes habían disminuido el tratamiento control y doce presentaron mejoría global. Conclusión: Omalizumab se ha utilizado en pacientes con asma grave alérgica no respondedores a terapia convencional observándose una disminución en el número de exacerbaciones y visitas a urgencias e ingresos. Sólo un 55% experimentan una mejoría global según criterios clínicos y no se observaron cambios estad

  20. Influence of pharmacotherapy complexity on compliance with the therapeutic objectives for HIV+ patients on antiretroviral treatment concomitant with therapy for dyslipidemia. INCOFAR Project.

    PubMed

    Jiménez Galán, Rocío; Montes Escalante, Ines María; Morillo Verdugo, Ramón

    2016-03-01

    Objetivos: Analizar la relación entre complejidad farmacoterapéutica y cumplimiento de los objetivos terapéuticos en pacientes VIH+ con tratamiento antirretroviral activo y concomitante para la dislipemia. Material y métodos: Estudio observacional retrospectivo. Se seleccionaron pacientes con VIH en tratamiento antirretroviral estable durante los últimos 6 meses y tratamiento para la dislipemia entre enero-diciembre de 2013. Se calculó el índice de complejidad a través de la herramienta desarrollada por Mc Donald et al. Otras variables analizadas fueron: edad; sexo; factor de riesgo de adquisición del VIH; consumo de tabaco, alcohol y drogas; alteraciones psiquiátricas; adherencia al TAR y a fármacos hipolipemiantes y parámetros clínicos (carga viral VIH, recuento de CD4, niveles plasmáticos de colesterol total, LDL, HDL, y triglicéridos). Para determinar factores predictivos asociados con el cumplimiento de los objetivos terapéuticos se realizó un análisis univariante mediante regresión logística y, posteriormente, un análisis multivariante. Resultados: Se incluyeron 89 pacientes. El 56,8% cumplieron los objetivos terapéuticos para la dislipemia. El índice de complejidad fue significativamente mayor (p = 0,02) en pacientes que no alcanzaron los valores objetivo (mediana de 51,8 vs 38,9). La adherencia al tratamiento hipolipemiante fue relacionada de forma significativa con el cumplimiento de los objetivos terapéuticos establecidos para el tratamiento de la dislipemia. El 67,0% cumplieron los objetivos para el TAR, sin embargo el índice de complejidad no fue significativamente mayor (p = 0,06) en los pacientes que no cumplían objetivos. Conclusiones: La complejidad farmacoterapéutica constituye un factor clave en la consecución de los objetivos de salud en pacientes VIH+ que reciben tratamiento para la dislipemia.