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Biomedical subjects

D B Geffen

Publications and source records attributed to D B Geffen.

At least 19 recordsLinked to original sources
PubMed2001

Primary malignant lymphoma of the prostate--a report of three cases.

We report the clinical, morphological and immunohistochemical findings in 3 cases of primary non-Hodgkins malignant lymphoma of the prostate. After treatment with doxorubicin-based chemotherapy, two patients achieved a complete remission, and 1 died of infective endocarditis three months after diagnosis. Until a consensus has been reached regarding the optimal treatment of prostatic lymphoma, therapy should be determined by the histologic type diagnosed and stage of the lymphoma.

Aged↗
PubMed2000

[Etoposide and cisplatin for non-small cell lung cancer: trial at the Soroka Medical Center 1986-1994].

Etoposide and cisplatin (EP) has been the standard therapy for non-small cell lung cancer (NSCLC) at many cancer centers for over a decade. We analyzed our experience with EP in NSCLC to provide a baseline for comparison with new drugs. From 1986 through 1994, 46 of our patients with NSCLC received EP as first-line chemotherapy. Radiation therapy was administered to 25 of them, including 20 who received it immediately before or concomitantly with chemotherapy. Toxicity was mild and included only 1 episode of neutropenic fever and 1 case of reversible renal failure. Overall response was 22%. In 3, response was complete (pathologically documented in 2 of them) and in 7 partial. Median survival in locally advanced (stage III) and metastatic disease (stage IV and recurrent) were 12 months and 7 months, respectively. 2 patients are alive and free of disease more than 6 years after diagnosis. Our results are consistent with other published studies of EP in NSCLC. EP provides modest benefit in locally advanced NSCLC, with minimal toxicity.

Adult↗
PubMed2000

A worrying increase in the incidence of mesothelioma in Israel.

BACKGROUND: Exposure to asbestos is the main established cause of mesothelioma; the incidence of this tumor is thus often interpreted as an index of past exposure. Asbestos has been widely used in Israel in industry and building, exposing certain population groups to the risk of developing mesothelioma. OBJECTIVES: To analyze the incidence of mesothelioma in Israel during the years 1960-96, and to project its trend for the following years. METHODS: We conducted a population-based study of the incidence of mesothelioma reported to the Israel Cancer Registry during 1960-96. Time trends were analyzed from data on the annual import of asbestos to Israel, which may indicate the magnitude of past exposure. Based on these findings, trends in the incidence of mesothelioma in Israel were projected for the subsequent years. RESULTS: A total of 327 cases of mesothelioma were reported to the Israel Cancer Registry during the study period. The incidence in Jews was higher than in Arabs (age-standardized incidence rate 2.64 vs. 1.35 per million/year, respectively). Among the Jewish population, Israeli-born males and males born in Europe and America showed the highest incidence (ASR 4.23 and 4.15 per million/year, respectively). Israeli-born males were 20 years younger than Jewish males born elsewhere. The incidence was twice as high among males than females and increased sevenfold from its nadir (1.17 per million/year) in 1978-80 to its peak (8.5 per million/year) in 1993-96. During a similar period the incidence among females increased from 0.33 to 2.56 per million/year. The incidence in both sexes does not appear to level off. The large wave of immigration from the former Soviet Union that began in 1989 only partly accounts for the increased incidence in 1993-96. The time trend in the incidence of mesothelioma in both sexes parallels the use of asbestos in Israel, which peaked in the years 1976-78. CONCLUSIONS: The incidence of mesothelioma in Israel has increased sharply in recent years, unrelated to a wave of immigration from East Europe, and is predicted to continue to rise for another 10-15 years.

Adult↗
PubMed1998

Metastatic angiosarcoma of the spleen after accidental radiation exposure: a case report.

Angiosarcoma is a rare malignant tumor arising from endothelial cells of blood vessels or lymphatic channels. Therapeutic irradiation, thoriumdioxide administration, pyothorax, and polyvinyl chloride exposure have been shown to be predisposing factors for developing angiosarcoma. Accidental radiation exposure has not been associated with angiosarcoma. We present an unusual case of angiosarcoma of the spleen, with metastases to bone, liver, breast, and bone marrow, in a woman who lived near the Chernobyl nuclear facility in the former Soviet Union at the time of the reactor accident in 1986. To the best of our knowledge, this is the first report of metastatic angiosarcoma after accidental radiation exposure.

Female↗
PubMed1997

Myasthenia gravis associated with malignant mixed Mullerian tumor of the uterus.

Myasthenia gravis is a neurologic disorder characterized by intermittent muscle weakness which improves after anticholinesterase medication. The pathogenesis of myasthenia gravis is associated with production of autoantibodies to nicotinic acetylcholine receptor in the motor end plate. Most patients do not have an underlying neoplasm, but in 10-15% of the cases, a thymoma may be detected. Apart from thymoma, no other tumor type or organ has consistently been associated with myasthenia gravis. We describe an unusual case of myasthenia gravis in a patient with malignant mixed Mullerian tumor of the uterine corpus. Initial histology revealed malignant mixed Mullerian tumor of a predominant carcinomatous element. At that time, there were no symptoms of muscle weakness. Intraabdominal metastases were detected later, concommitantly with symptoms of muscle weakness and the diagnosis of myasthenia gravis. Histology of the metastases disclosed an exclusive mesenchymal element with striated muscle differentiation. To the best of our knowledge this case is the first report of myasthenia gravis in a patient with malignant mixed Mullerian tumor of the uterine corpus. We propose that the mechanism contributing to myasthenia gravis in this patient was closely associated with the evolving histology and with the nature of the tumor, so that antibodies produced to muscle-like epitopes exposed by malignant cells could have cross-reacted with acetylcholine nicotinic receptors and caused myasthenia gravis.

Female↗
PubMed1997

Gluteal manifestation of advanced Hodgkin's disease.

Hodgkin's disease (HD) is a nodal malignancy with a characteristically axial pattern of spread and with contiguous progression via lymphatic channels. Even when dissemination occurs beyond the lymphoreticular system, certain patterns of associated spread are frequently evident. We describe a case of nodular sclerosis HD with a 12-year indolent course and late involvement of the gluteal muscle. Initially, stage was IVb with spleen and bone marrow involvement, complicated by a Coomb's positive hemolytic anemia. Following chemotherapy, the patient had a partial response with the subsequent long course of slowly progressive disease invading first the urinary bladder and, later, the gluteus. Involvement of the gluteal muscle is a rare event in HD. Spread to the gluteus occurred most likely by contiguity, via retroperitoneal lymph nodes.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

Isolated metastases to peripheral nerves. Report of five cases involving the brachial plexus.

BACKGROUND: Primary true isolated metastasis in a peripheral nerve trunk is considered a rare phenomenon. Several routes of tumor invasion of the peripheral nervous system from different types of cancer and in various anatomic locations have been described in the literature; however, the brachial plexus is an uncommon site of such blood-born metastases. METHODS: Five patients with severe brachial plexus neuropathy without obvious external signs of tumor masses and no detectable regional lymph node involvement underwent exploration of the plexus. RESULTS: Isolated metastatic deposits were identified inside the nerve trunks. Radiation therapy to the area of the lesion provided good symptomatic relief to all patients and local arrest of the disease to four of five. CONCLUSIONS: Despite its rich vascularity, the Peripheral nerve has relative resistance to metastatic spread because there are blood-nerve barriers. This barrier should be investigated further in a tumor model.

Adult↗
PubMed1995

Expression of c-myc and c-ras oncogenes in the neoplastic and non-neoplastic cells of Hodgkin's disease.

The oncogenes c-myc and c-ras are known to elicit a cooperative tumorigenicity. In this study we investigated their role in the pathogenesis of Hodgkin's disease. The expression of these oncogenes was determined in Hodgkin's disease patients by avidin-biotin peroxidase complex immunohistochemical staining and was compared to their expression in patients with non-Hodgkin's lymphomas and inflammatory reactive lymph nodes. Of 29 examined patients with different histological types of Hodgkin's disease, 21 (72.4%) showed an elevated expression of c-myc and 28 (96.5%) of c-ras. Although this expression was marked especially in the neoplastic Reed-Sternberg cells, it was also noted in the numerous reactive cells present in the involved lymph nodes. By contrast, a much lower frequency of increased expression of these oncogenes was recorded in 19 patients with different grades of non-Hodgkin's lymphoma and in 29 patients with inflammatory reactive lymph nodes. The elevated expression of c-myc and c-ras in the neoplastic Reed-Sternberg cells may reflect an oncogenic event that directly activates these genes. However, their increased expression in the surrounding non-neoplastic cells probably results from signal transduction induced by certain growth-promoting factors possibly released by the Reed-Sternberg cells and that act paracrinally to stimulate the proliferation of the neighboring cells. Furthermore, the continuous c-ras elevation may impair the normal cell cycle control and thereby promote mutagenesis and overt malignancy.

Gene Expression↗
PubMed1993

Primary small noncleaved cell lymphoma of the liver. Report of an adult case in complete remission after treatment with combination chemotherapy.

Open liver biopsy in a 34-year-old woman with hepatosplenomegaly showed small noncleaved cell lymphoma. Except for an enlarged spleen, there was no evidence of other sites of involvement. She was treated with combination chemotherapy and is alive and free of disease > 5 years after diagnosis. We believe this to be the first reported case in an adult of primary hepatic or hepatosplenic lymphoma of the small cleaved cell type with long-term disease-free survival.

Adult↗
PubMed1993

Basal cell carcinoma of the male nipple. Case report and review of the literature.

BACKGROUND: Basal cell carcinoma (BCC) of the nipple is a very unusual occurrence, often mistaken for Paget's disease. OBJECTIVE: By reporting a further case of BCC of the nipple in a 57-year-old man and by reviewing the sixteen previously reported cases, we mean to characterize further a common lesion arising at an unusual site. We also wish to stress the lack of agreement regarding the treatment of BCC of the nipple. METHODS: Review of the literature was based on a search in Medline. CONCLUSIONS: We appeal to compile all cases of BCC arising at unusual locations in order to gain a better understanding of these lesions.

Biopsy↗
PubMed1992

Testicular carcinoma with inferior vena cava thrombosis extending into the right atrium treated with chemotherapy and anticoagulation.

A 34-year-old male with pulmonary emboli and thrombosis of the inferior vena cava extending into the right atrium was found at presentation to have a mixed seminoma and embryonal cell testicular carcinoma with high-volume retroperitoneal disease and visceral metastases. The patient was free of disease 19 months after treatment with combination chemotherapy and anticoagulation followed by resection of the residual mass. We could not find any previous report of a patient with bulky retroperitoneal disease and vena cava thrombosis successfully treated with chemotherapy without vena cava resection.

Adult↗
PubMed1991

Pulmonary lymphangioleiomyomatosis. Report of a case with associated multiple soft-tissue tumors.

We describe a 55-year-old woman with pulmonary lymphangioleiomyomatosis. The patient died of respiratory failure 9 years after diagnosis. An autopsy confirmed the diagnosis and disclosed multiple soft-tissue tumors, including a large solitary fibrous tumor of the lung, a huge cavernous hemangioma of the liver, a meningioma of the right pontocerebellar angle, and a focus of nodular stromal hyperplasia of the ovary. In addition, endocrine tumors, including a papillary carcinoma of the thyroid gland and a parathyroid adenoma, were also found. There was no evidence of tuberous sclerosis or angiomyolipoma of the kidney. The connection between pulmonary lymphangioleiomyomatosis and tuberous sclerosis is discussed.

Female↗
PubMed1986

Comparison of the bioavailability of uridine in mice after either oral or parenteral administration.

We compared the bioavailability of uridine (Urd) (350 and 3500 mg/kg) administered either as a single SC injection or by gavage, in male CD8F1 mice. Plasma samples were analyzed for Urd and uracil (Ura) using high-pressure liquid chromatography. After Urd (3500 mg/kg, SC), plasma Urd levels peaked at 4900 microM and then declined to pretreatment levels (less than 10 microM) within 6 h. Plasma Ura concentrations peaked at 1400 microM and then declined initially more slowly than Urd. After Urd (3500 mg/kg, PO) plasma levels of Urd were fairly constant (range 33-82 microM) for up to 8 h and had returned to pretreatment levels at 16 h. Plasma Ura concentrations paralleled Urd, but were approximately ten-fold higher. Areas under the concentration-time curve for Urd showed that the bioavailability of Urd after PO administration was 7% of that after SC administration. After Urd (350 mg/kg, SC) Urd levels peaked at 210 microM returning to pretreatment levels within 2 h. Plasma Ura levels reached a peak with 300 microM and then declined initially more slowly than those of Urd. After Urd (350 mg/kg, PO) plasma Urd levels were not perturbed, although Ura levels peaked at 50 microM after which they declined and could no longer be detected at 4 h. These data indicate that the bioavailability of Urd (350 or 3500 mg/kg) was lower when given PO than when it was administered by SC injection; and Urd (3500 mg/kg) PO resulted in prolonged and relatively constant plasma Urd levels compared with Urd (3500 mg/kg) SC. These results suggest that Urd PO should be compared with parenterally administered Urd in attempts to increase the therapeutic index of 5-fluorouracil and of antimetabolite inhibitors of de novo pyrimidine biosynthesis.

Administration, Oral↗
PubMed1985

Renal involvement in diffuse aggressive lymphomas: results of treatment with combination chemotherapy.

Nine (5.1%) of 175 patients with advanced disseminated diffuse aggressive non-Hodgkin's lymphoma presented with renal involvement and were initially treated with combination chemotherapy alone. These patients were classified as having renal involvement based on histologic and radiographic criteria. Five of the nine patients presented with a serum creatinine level greater than 2.5 mg/dL. Four patients achieved a complete remission of all systemic disease. Eight patients had complete resolution of renal involvement. Two patients later had recurrent renal disease associated with other sites of recurrence. All five patients who presented with an elevated serum creatinine level recovered normal renal function; in fact, four patients had normal renal function by the end of the first cycle of therapy. No patient required hemodialysis. Only one patient remains alive and free of disease at 55 months; five patients have died with disseminated disease; two patients have died without evidence of disease; and one patient was lost to follow-up while in remission. Initial local control of renal involvement including normalization of renal function in diffuse aggressive lymphoma can be rapidly achieved by combination chemotherapy alone.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Alveolar bone necrosis and tooth loss. a rare complication associated with herpes zoster infection of the fifth cranial nerve.

Eleven case reports involving herpes zoster infection associated with alveolar bone necrosis and tooth loss were reviewed in order to develop a patient profile for this rare combination of physical findings. The clinical course of a 56-year-old white woman with herpes zoster infection of the fifth cranial nerve and related alveolar bone necrosis, tooth loss, and oroantral fistula development is reported. The etiology and management of herpes zoster infection associated with destructive oral sequelae are discussed.

Alveolar Process↗