Rhabdomyolysis, when observed with high-dose interferon-alfa (HDI) therapy, does not always exclude resumption of HDI.
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Biomedical subjects
Publications and source records attributed to B Mascarenhas.
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Immunotherapy with high-dose recombinant interleukin-2 is an effective therapy for selected patients with metastatic renal cell carcinoma (RCC). Objective responses (complete or partial) are observed in about 15% of treated patients. The overall and disease-free survival of patients with a complete response are significantly prolonged. Although RCC is known to spread hematogenously, isolated RCC metastasis to the stomach is a rare event. Recurrent RCC, after a complete response to interleukin-2, presenting clinically as an isolated gastric metastasis, has not been reported to date. In this report, we describe the clinical course of a patient with metastatic RCC who had a complete response to high-dose interleukin-2 and was disease free for 4 years before presenting with massive upper gastrointestinal hemorrhage due to an isolated gastric metastasis. The patient remained disease free for 3 years after resection of the metastasis. Metastatic RCC to the stomach, although rare, should be suspected in any patient with a history of RCC who presents with gastrointestinal symptoms. In the absence of diffuse disease, aggressive therapy, including surgical resection, is appropriate for isolated gastric metastasis, because prolonged survival is possible.
In a patient with a disrupted silicone prosthesis, the presence of a swollen articulation should suggest the presence of silicone-induced reactive synovitis. Diagnosis of the entity rests on the identification of particulate matter by polarized microscopy and/or scanning electron microscopy--studies that will not be performed routinely unless the diagnosis is suggested preoperatively. The case presented is that of a 68-year-old woman in whom a silicone elastomer trapeziometacarpal prosthesis had been implanted 5 years previously. Painful swelling had ensued, and biopsy confirmed the diagnosis.