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At least 163 records · Page 9Linked to original sources
PubMed1998

Recurrent malignant acrospiroma. Treatment by chest wall excision.

Malignant acrospiroma is an uncommon tumor of the eccrine sweat gland. In contrast to its relatively more common benign counterpart, malignant acrospiroma is highly invasive, often with significant lymphatic and distant metastasis. The establishment of this diagnosis is difficult on both clinical and histopathologic grounds. After diagnosis, wide surgical excision is warranted to completely extirpate these lesions. We report the case of a 66-year-old female with a recurrent malignant acrospiroma. This patient's tumor was removed by wide radical resection, including chest wall excision, followed by reconstructive surgery and radiotherapy. After 16 months there is no evidence of local recurrence or distant metastasis.

Acrospiroma↗
PubMed1990

Primary neoplasms of the thoracic and lumbar spine. An analysis of 29 consecutive cases.

Primary osseous neoplasms of the thoracic and lumbar spine are uncommon lesions. Between 1965 and 1982, of 1971 patients with musculoskeletal neoplasms, only 29 (1.5%) had primary osseous tumors in these locations. There were eight children and 21 adults. Back pain was the most common complaint in 25 patients (86%), and neurologic symptoms or deficits were present in 16 patients (55%). All lesions were visible on routine spine roentgenograms, while computed tomography and myelography demonstrated spinal canal encroachment and extradural spinal cord compression in 19 patients (66%). The histologic diagnoses included 11 benign and 18 malignant lesions. Benign lesions occurred predominantly in children and malignant tumors in adults. Treatment was individualized, based on the histologic diagnoses. Twenty-two patients had surgical resection of their lesions. Laminectomy without stabilization and arthrodesis resulted in late instability and neurologic deterioration in three of seven patients (43%) with malignant lesions. Resection and decompression combined with arthrodesis did not predispose to late instability. Twenty-one patients were followed for a mean of 4.1 years (range, two to 14 years). Eight patients died from malignant disease between one month and seven years after diagnosis.

Adolescent↗
PubMed1989

[Reconstruction of the thoracic wall in neoplasms of the manubrium of sternum].

The case of a voluminous neoplasia originating at the manubrium sterni is described. Given the rapid growth of the mass and its dimensions, the mass was removed surgically together with the manubrium sterni and the sternal extremity of the clavicle and of the first two ribs. The defect in the anterior wall of the thorax was filled by a net of prolene partially covered with the mobilised pectoral muscles. Functional and aesthetic results were very good. Assisted respiration was not necessary in the immediate postoperative period and the net remained stable and firmly in place during respiration. One month after the operation, respiratory function tests were on a par with those done prior to the operation. The positioning of prolene nets for the reconstruction of the thoracic wall is an extremely effective technique which makes it possible to preserve satisfactory respiratory mechanics even after the removal of extensive portions of the thoracic wall.

Female↗
PubMedDate not supplied

[Thoracic esophageal neoplasm-therapeutical problems and post-surgery evolution].

The authors are presenting a few considerations on Thoracic Esophageal Neoplasm, as resulted from an 18-cases study performed on patients that were operated between 1994-1999. The esophageal resection rate was of 50%, as follows: 7 Esophageal Resections and 2 Superior Polar Esogastric Resections. The digestive transit was reestablished by means of intrathoracic transposition of the stomach (6 cases) or of the right ileo-colon (2 cases). In one of the cases an Esogastric Anastomosis was performed at the neck level (cervical-right). Immediate post-op mortality after Esophageal Resection (1 case) was due to an acute respiratory distress syndrome (ARDS). The post-op complications were as follow: one anastomotic fistula associated with a purulent pleurisy, 4 non-infectious pulmonary complications and 2 cardiac complications (paroxysmal supraventricular tachycardia). The Discussions and Conclusions of the present work are presenting samples of surgical techniques, post-op complications and prognosis.

Aged↗
PubMed2000

MR imaging of thoracic trauma.

Although MR imaging and MR angiography should not be considered a primary study for patients sustaining blunt or penetrating thoracic trauma, it has achieved importance as an ancillary problem-solving modality. In general, the authors have found MR imaging to be a useful ancillary study to confirm or exclude diaphragm injury, if spiral CT scan with reformations are equivocal; to help assess the aorta and mediastinum in cases of potential injury that are not clarified by CT scan or thoracic angiography; and to identify the true origin of trauma-related masses that may simulate thoracic neoplasms.

Aorta↗
PubMed1995

Recurrent chylothorax associated with sarcoidosis.

Spontaneous chylothorax, an uncommon manifestation of pulmonary disease, has been described in association with infectious and inflammatory conditions involving the chest, thoracic trauma, and thoracic neoplasms. Isolated chylothorax is a rare manifestation of sarcoidosis and is usually associated with the presence of mediastinal and hilar adenopathy causing obstruction of the thoracic duct. We report a case of recurrent spontaneous chylothorax in a patient with parenchymal sarcoidosis without hilar or mediastinal adenopathy.

Adult↗
PubMed2005

Neurocytoma-like neoplasm of the thoracic spine in a 15-month-old child presenting with diffuse leptomeningeal dissemination and communicating hydrocephalus. Case report.

This unusual mixed glioneuronal neoplasm of the spine resembling central neurocytoma is only the second reported example of a neoplasm of this type involving the spinal cord and is, seemingly, the first to present with diffuse leptomeningeal dissemination and communicating hydrocephalus. This 15-month-old boy presented with somnolence, bilateral sixth nerve palsy, and lower-extremity weakness and was found to harbor a primary neoplasm within the thoracic spine and associated syrinx, widespread leptomeningeal dissemination, and communicating hydrocephalus. The patient underwent cerebrospinal fluid shunt placement, thoracic laminectomy for tumor debulking and biopsy, chemotherapy, and radiation therapy to the neuraxis. Immunohistochemically, the tumor was marked by evidence of mixed glial (glial fibrillary acidic protein-positive) and neuronal (synaptophysin-positive) differentiation. Mitotic activity was inconspicuous. No areas of vascular proliferation, necrosis, or marked nuclear pleomorphism were noted. Mixed glioneuronal neoplasms are a heterogeneous group of tumors whose biological potential remains incompletely defined. The present case illustrates the reality that some of these neoplasms can be clinically aggressive, despite comparatively bland histological features. The authors' goal is to acquaint neurosurgeons with the expanding spectrum of mixed glioneuronal neoplasms and with the potential of some of these lesions to pursue an aggressive clinical course.

Arachnoid↗
PubMed1997

[Diagnosis and staging of thoracic tumors].

During the last 5 years researches, studies, training and practical experiences in both fields of diagnosis and therapy have been carried out with the specific aim to promote and support thoracic surgery in hospital departments where general surgery is mainly performed. Criteria and methods suggested as guidelines for the diagnosis and staging of thoracic neoplasms are herein shortly described. This phase has gained fundamental importance due also to the more and more frequent use of integrated therapy. The article reports the problems related to the III A-B stage of NSCLC, to the differential diagnosis between thymoma and lymphoma in mediastinal masses as well as the problems related to the diagnosis of mesothelioma. It is also acknowledged the great importance of VTS during the diagnostic phase, and in solving many thoracic problems.

Biopsy, Needle↗
PubMed1990

[CT guided selective pneumomediastinography in thoracic imaging].

We established new approaches for CT guided selective pneumomediastinography; paravertebral, pretracheal and anterior mediastinal approaches. CT would seem to be useful method for assessing the invasion to the neighboring structures in the thoracic neoplasms. But scanty fat in mediastinum often interferes with correct evaluation of mediastinal structures in conventional CT. Pneumomediastinal CT with our methods overcomes the weak point and provides additional information to enable exact diagnosis. The feasibility and security of these methods were confirmed through applying to many cases. Based upon these results, selective pneumomediastinal CT would be considered to be advantageous and advisable on the CT diagnosis in thoracic imaging.

Aged↗
PubMedDate not supplied

Interactive three-dimensional volume rendering of spiral CT data: current applications in the thorax.

Spiral computed tomographic (CT) data sets coupled with a real-time volume-rendering technique allow creation of accurate three-dimensional (3D) images that can be used for a wide range of clinical applications. The image contrast of and relative pixel attenuations in the final image can be interactively modified by the user in real time by manipulating trapezoidal transfer functions. Although 3D images are not required for diagnosis, they aid both radiologists and referring clinicians by demonstrating anatomic relationships and the extent of disease, particularly for vessels oriented in the z axis. Three-dimensional imaging of the vasculature and airway structures has many advantages, including the potential to obviate invasive procedures such as angiography and bronchoscopy. Clinical applications of volume rendering of spiral CT data include cardiovascular imaging (aorta, pulmonary vasculature, and venous abnormalities), staging of thoracic neoplasms (mediastinal and pulmonary masses), tracheobronchial imaging, and imaging of chest wall disease.

Adult↗
PubMedDate not supplied

Sequential 5-Aza-2 deoxycytidine-depsipeptide FR901228 treatment induces apoptosis preferentially in cancer cells and facilitates their recognition by cytolytic T lymphocytes specific for NY-ESO-1.

Global alterations in chromatin structure profoundly influence gene expression in thoracic neoplasms, silencing tumor suppressors while facilitating the expression of various cancer testis antigens such as NY-ESO-1. Although recent studies have shown that histone deacetylase inhibitors can potentiate tumor suppressor gene induction mediated by demethylating agents in cancer cells, the ability of these agents to augment cancer testis antigen expression have not been fully defined. The authors designed the current study to determine whether the histone deacetylase inhibitor, depsipeptide FR901228 (DP), could enhance NY-ESO-1 induction mediated by the DNA demethylating agent 5-Aza-2'-deoxycytidine (DAC) in cell lines established primarily from thoracic cancers. Quantitative reverse-transcriptase polymerase chain reaction analysis revealed that, under exposure conditions potentially achievable in clinical settings, DAC dramatically induced NY-ESO-1 expression in cultured cancer lines. DP alone mediated negligible target gene induction but significantly augmented DAC-mediated induction of NY-ESO-1. After DAC or sequential DAC-DP treatment, HLA-A*0201 cancer cells were recognized by an HLA-A*0201 CTL specific for NY-ESO-1. Although sequential DAC/DP exposure did not uniformly enhance immune recognition of target cells compared with DAC alone, this treatment mediated profound induction of apoptosis in cancer cells but not normal human bronchial epithelia. The apoptotic effects of DAC, DP, or sequential DAC-DP did not correlate in an obvious manner with histology, or the magnitude of NY-ESO-1 induction in cancer cells. Although the mechanisms have not been fully defined, sequential DAC-DP treatment may be a novel strategy to augment antitumor immunity in cancer patients.

Anti-Bacterial Agents↗
PubMed2001

Thoracic imaging of pediatric lymphomas.

Lymphoma (Hodgkin and non-Hodgkin types) is the most common intra-thoracic neoplasm in the pediatric age group. Diagnostic strategies and treatment approaches for these tumors are largely determined by protocols established by one of the large, multi-institutional cooperative groups. In this paper, Hodgkin and non-Hodgkin lymphoma is discussed in the context of these cooperative group protocols. The basic biology, patterns of primary and metastatic disease distribution, treatment approaches, imaging follow-up, and areas of active research are discussed.

Child↗