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Biomedical subjects

A Shirkhoda

Publications and source records attributed to A Shirkhoda.

At least 37 records · Page 2Linked to original sources
PubMed1989

Clinical and radiological correlation of retroperitoneal metastasis from nonseminomatous testicular cancer treated with chemotherapy.

Forty patients with retroperitoneal metastasis from nonseminomatous testicular cancer treated with chemotherapy were retrospectively studied to (1) evaluate the predictive value of mass size as detected by computerized tomography (CT) as an indicator for postchemotherapy surgery and (2) determine the factors that influence relapse. Patients received two further courses of chemotherapy after their serum biomarkers became normal and computed tomography indicated a complete response or presence of a residual but stable mass. We found that patients with initial metastases less than 2 cm had a low frequency (14%) of residual masses after chemotherapy, vs. 59% for those with masses of 2-5 cm and 75% for those with masses of greater than 5 cm (P = 0.03). Of 22 patients with primary embryonal carcinoma, three of seven (43%) with residual masses after chemotherapy had mature teratoma at surgery. Six patients had small (1-2 cm) residual abnormalities that were not removed, and three of these patients relapsed. In conclusion, increasing size of retroperitoneal metastasis by CT scan predicts for increased likelihood of a residual mass after chemotherapy; patients who have a residual mass greater than or equal to 1 cm require retroperitoneal lymphadenectomy after chemotherapy, whether the tumor histology is embryonal carcinoma or teratoma. The role of surgery for patients who have residual retroperitoneal masses less than 1 cm after chemotherapy could not be determined from our study.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Peroneal nerve dysfunction as a complication of lateral meniscus repair: a case report and anatomic dissection.

A case report is presented in which a complete peroneal nerve palsy complicated lateral meniscus repair. The meniscal repair was performed using the combined method of arthroscopically placed inside-out needles and a posterior incision to view their exit. A cadaver limb was then used to examine the anatomy of lateral meniscus repair. Needles used for meniscus repair were passed into the posterior horn of the lateral meniscus using the inside-out and the outside-in methods. Computerized axial tomography (CAT) was then used to establish the proximity of the needles to the peroneal nerve in the posterolateral corner. The inside-out needles were dangerously close to the peroneal nerve. The outside-in needles had a larger margin of safety. The posterolateral corner was then dissected to verify and photograph these relationships.

Arthroscopy↗
PubMed1989

Leiomyosarcoma of the renal vein: radiologic pathologic correlation.

Leiomyosarcoma of the renal vein is a rare neoplasm occurring more commonly in women. On sectional imaging it is difficult to differentiate from other primary retroperitoneal tumors. Here is a case report of a right renal vein leiomyosarcoma in a 40-year-old man. The ultrasound findings are described and the magnetic resonance imaging, computed tomography, and angiographic findings are illustrated and correlated with the pathologic findings.

Adult↗
PubMed1989

Extraosseous Ewing's sarcoma. Computed tomography evaluation before and after chemotherapy.

Fourteen patients with extraosseous Ewing's sarcoma were evaluated by computed tomography (CT) and conventional radiography. The sites of involvement were in the lower extremities (six cases), the chest wall (four), pelvis (two), and the paravertebral region (two). In seven cases, the initial contrast-enhanced CT disclosed a necrotic soft tissue mass in four, two of them with peripheral enhancement. In three cases, the mass was homogeneous and did not enhance. CT enabled us to detect the size of the mass, the integrity of adjacent bone and medullary cavity, and to determine the presence or absence of metastases. CT was useful for evaluation of the patients' tumor response to treatment. In three of four patients treated with chemotherapy, CT showed evidence of a dramatic initial response. In one patient who was resistant to chemotherapy, surgical methods were required.

Adolescent↗
PubMed1989

Osteosarcoma metastatic to the kidney.

Two clinically silent renal metastatic lesions from primary osteogenic sarcoma were first detected on radionuclide bone scan. A needle biopsy performed under the guidance of abdominal ultrasonography confirmed the diagnosis. Prior to nephrectomy, further definition of the metastatic lesion was attained using enhanced computed tomography. A review of the English literature revealed only six previous cases of metastatic osteosarcoma detected in the kidney prior to autopsy.

Adolescent↗
PubMed1989

The many faces of neuroblastoma.

Neuroblastoma is a common tumor in childhood. It arises in the adrenal gland or in various extraadrenal primary sites of the sympathetic chain. Clinically, it may present as an abdominal mass or as disseminated metastatic disease. We studied 52 patients with neuroblastoma, and the typical and unusual radiographic features of the disease are presented.

Adrenal Gland Neoplasms↗
PubMed1988

Clinical and radiologic staging of locally advanced and inoperable bladder carcinoma.

Twenty-seven patients with locally advanced and inoperable bladder carcinoma (LABCa) were referred for chemotherapy. All were staged by cytoscopy, examination under anesthesia, and computed tomography (CT), and 18 also had bipedal lymphangiography (LAG). In 16 patients (56%), there was agreement between the clinical and the CT staging of the primary bladder tumor. In four of these 16 patients, CT detected lymphadenopathy in three and demonstrated pelvic bone invasion in one. Of the remaining 11 patients, CT underestimated the local extent of the bladder tumor in nine and overestimated in two. Lymphangiography was abnormal in nine patients (50%), in four of whom the abnormality was not seen on CT scan. Among the ten patients with normal LAG, six had abnormal pelvic nodes detected by CT. The LAG affected the overall staging of the tumor in five patients (16.6%). The total incidence of nodal metastasis as seen on CT, LAG, or both was 72%. Although CT and LAG may not add significantly to the clinical staging of the primary tumor in LABCa, they will affect the overall staging of the tumor by detecting lymphadenopathy. Accurate staging of these patients is important because, with aggressive chemotherapy, some of these patients might become candidates for more radical treatment such as surgery or radiotherapy.

Adult↗
PubMed1988

Anterior dynamic imaging of the liver and spleen.

Anterior dynamic imaging of the abdomen was performed in 870 patients using a large field-of-view (LFOV) gamma camera. Sequential images were obtained immediately after the injection of Tc-99m sulfur colloid (Tc-99m SC) in an antecubital vein for liver-spleen imaging and was followed by standard planar images. This provided additional information in 172 cases (20%), including such findings as determination of the lesion's vascularity in 76 (9%), visualization of abnormal portal blood flow in 53 (6%), and detection of abnormalities in the aorta, inferior vena cava, iliac vessels, or kidneys in 43 (5%) of these patients. This procedure is recommended in all patients undergoing liver-spleen imaging.

Adult↗
PubMed1988

Expansile bone lesions of the vertebra.

Vertebral expansion may be caused by both benign and malignant disease processes. Recognition of such lesions on radiographs facilitates accurate diagnosis in many cases.

Bone Cysts↗
PubMed1988

Improved tumor localization with increasing dose of indium-111-labeled anti-carcinoembryonic antigen monoclonal antibody ZCE-025 in metastatic colorectal cancer.

Monoclonal antibodies (MoAbs) against carcinoembryonic antigen (CEA) react with human colorectal cancer cells, and when labeled with a gamma-emitting radioisotope, may help to localize known and occult metastatic disease. We tested ZCE-025 (Hybritech, Inc, San Diego), a high-affinity immune gamma globulin1 (IgG1) MoAb anti-CEA that does not react with normal granulocyte glycoproteins in a phase I/II trial to determine the reagent's toxicity and its maximum efficacy in detecting metastatic colorectal cancer. Increasing doses of unlabeled ZCE-025 were mixed with 1 mg of Indium-111 (111In)-radiolabeled MoAb and administered intravenously (IV) to 34 patients who had metastatic colorectal cancer. Planar nuclear or single photon emission computed tomographic (SPECT) scans were performed 48 to 72 and 120 to 144 hours later. Total dose of MoAb and scanning sensitivity (number of imaged lesions/number of known lesions) were correlated up to 80 mg. At doses of 2.5 to 20 mg, a mean of 22% of the lesions were imaged; at 40 mg, 77% were imaged (P less than .01). Liver metastases were detected as areas of increased activity ("hot") at the 40 mg dose but showed decreased MoAb uptake at lower doses. At the 40 mg dose normal liver parenchymal uptake of the labeled MoAb was lower with respect to blood pool compared with the other doses. At 80 mg, however, sensitivity of detection declined to 21%. One milligram of 111In-labeled ZCE-025 antibody coinfused with 39 mg of unlabeled antibody appeared optimal for detecting metastatic colorectal cancer, particularly in the liver. Although the exact mechanism(s) for this dose effect is currently unknown, a partial "blocking" effect of unlabeled antibody with a change in MoAb biodistribution may be occurring.

Adult↗
PubMed1988

The growing teratoma syndrome: an unusual manifestation of treated, nonseminomatous germ cell tumors of the testis.

Residual masses are a common finding after chemotherapy for retroperitoneal and other metastases from nonseminomatous germ cell tumors of the testis. These may contain mature teratoma, fibrotic tissue, or tumor. Mature teratoma, which is unresponsive to chemotherapy, may result from evolution of a malignant lesion during treatment, or it may represent a metastasis from a focus of mature teratoma in the primary testicular tumor. An enlarging retroperitoneal mass during the course of chemotherapy is usually due to treatment failure but rarely may be due to an enlarging mature teratoma, the so-called growing teratoma syndrome. This report concerns five patients with nonseminomatous germ cell tumors metastatic to the retroperitoneum in whom mature teratomas were found at surgery. These tumors had grown despite the administration of combination systemic chemotherapy, and the cystic component had increased in size. Three patients had evidence of urinary tract compression, three had vascular compression or displacement, and one had gastrointestinal compression. The retroperitoneal mass was excised in each patient, and all are alive 4-27 months after surgery without evidence of recurrence. Growing mature teratoma is unresponsive to chemotherapy but is cured by surgical excision. The possibility of the growing teratoma syndrome should be considered so that these lesions can be treated appropriately.

Adult↗
PubMed1987

Computed tomography of rectal and perirectal disease in AIDS patients.

Twenty-eight homosexual men with Kaposi sarcoma as part of the acquired immune deficiency syndrome (AIDS-related KS) and 2 homosexual men without AIDS were examined with abdominal and pelvic computed tomography (CT). Abnormalities of the rectum and perirectal areas were seen in 8 of the 30 patients on CT examination. Endoscopy and biopsy of the colon in these 8 cases revealed inflammatory changes in 6 patients and KS in 2. The CT abnormalities were not specific for inflammatory disease or tumor, and endoscopy with biopsy was necessary to establish an accurate diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Renal sarcoma and sarcomatoid renal cell carcinoma: CT and angiographic features.

Computed tomographic (CT) and angiographic findings in 14 patients (eight men, six women, aged 30-72 years) with sarcomatoid renal cell carcinoma (SRCC) and various types of renal sarcoma are described. There were four patients with SRCC; three, leiomyosarcoma; two, liposarcoma; two, fibrosarcoma; and one each of unclassified renal sarcoma, clear cell sarcoma, and malignant fibrous histiocytoma. The most frequent presenting symptom was an abdominal mass or pain. All 14 patients underwent CT, and 11 underwent selective renal angiography. The diagnosis of renal sarcoma should be suspected when CT findings suggest that the tumor arises from the renal capsule or renal sinus and when the tumor is hypovascular or avascular on angiograms. The characteristic negative attenuation values for liposarcomas permit a specific diagnosis. Sarcomas that originate in the renal parenchyma and SRCC cannot be easily differentiated from renal cell carcinoma; however, renal sarcomas do not appear to have a propensity for extension into the renal vein or the inferior vena cava.

Adult↗
PubMed1987

Lymphangiography and CT in the follow-up of patients with lymphoma.

One hundred twenty-six patients with the diagnosis of lymphoma underwent staging with both lymphangiography and computed tomography (CT) of the abdomen and pelvis. These patients were retrospectively studied to determine the optimal imaging modality for follow-up. Six hundred seventy-four CT scans were correlated with 138 lymphangiograms and 840 follow-up KUB (kidney, ureter, bladder) radiographs. In 21 patients there was evidence of relapse, and in 105 the disease had regressed or remained stable. In all patients with evidence of progression or regression on the CT scan, there was a concomitant change in opacified lymph nodes on the KUB radiographs. It is recommended that the initial staging of lymphoma be done with lymphangiography and CT. If the findings of both are positive, then follow-up should consist of only KUB radiography. If progression is detected, restaging with CT may also be performed. This approach will not only reduce the radiation dose but will also save time and money and enable a more efficient use of radiologic equipment.

Abdominal Neoplasms↗
PubMed1987

Pelvic exenteration: role of CT in follow-up.

Fifty-five computed tomography (CT) scans of the pelves and abdomens of 33 patients who had undergone pelvic exenteration were reviewed. There were 27 gynecologic and six colorectal malignancies. The interval between surgery and the first CT scan ranged from 2 weeks to 37 months (median, 8 months). CT findings included abnormal fluid collections (33.3%), abnormalities of the neovagina (30.3%) and presacral soft tissues (36.4%), increased hydronephrosis (54.5%), and lymphocysts (6.1%). Tumors recurred in 17 of 33 patients (51.5%) at a median interval of 9 months after surgery and had several CT manifestations. The most common of these was a soft-tissue mass of variable density and shape, but pelvic fluid collections as well as abnormalities of the neovagina and presacral soft-tissue layer were also associated with tumor recurrence. The surgical indications, methods, and potential post-operative complications of pelvic exenteration were reviewed and the role of CT in the follow-up of these patients was emphasized.

Abscess↗