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Biomedical subjects

C Zornig

Publications and source records attributed to C Zornig.

At least 55 records · Page 3Linked to original sources
PubMed1995

Post-irradiation soft tissue sarcoma.

From 1975 to 1993, 11 of 375 patients treated for soft tissue sarcoma presented with post-irradiation sarcoma. The mean time interval between irradiation therapy and onset of the second neoplasm was 15.8 years (4-31 years). The total radiation dosage ranged from 12 to 60 Gy with a mean of 40 Gy. All patients had complete staging including CT or MRI of the tumour site, and CT of the lung. Surgical resection was the treatment of choice. Wide margins could be achieved in 10 patients. One had a marginal resection. Tumours included malignant fibrous histiocytoma, haemangiosarcoma, rhabdomyosarcoma, malignant schwannoma, fibrosarcoma and undifferentiated sarcoma. All patients were reassessed in our outpatient clinic. After a mean follow-up of 4.7 years (1.0-11.5 years), only 1 patient had died because of the tumour. Although post-irradiation sarcomas are rather infrequently observed, these tumours must be suspected when alterations or symptoms occur in a previously irradiated region. Early detection provides the chance of curative, wide margin resection.

Adolescent↗
PubMed1995

[Incomplete ileus of carcinoid tumor of the small intestine--limits of laparoscopic surgical technique].

A patient with small bowel obstruction is presented. Separating adhesions at the terminal ileum laparoscopically a carcinoid tumour at Bauhin's valve was overlooked. Two weeks later the patient was resubmitted because of obstructive problems and the tumour was diagnosed at a conventional laparotomy. Basing on this case problems of laparoscopic treatment of bowel obstruction are discussed in general, and in special the decreased tactile abilities of the surgeon are mentioned.

Carcinoid Tumor↗
PubMed1995

Laparoscopic splenectomy. Technique and results in a series of 27 cases.

Between early 1992 and December 1994, laparoscopic splenectomy was performed in 27 patients with idiopathic thrombocytopenia (ITP), hairy-cell leucemia, HIV, or Hodgkin's disease. In all cases medical treatment, especially cortisone therapy, failed. In Hodgkin's disease the splenectomy was combined with liver biopsies and dissection of parailiacal, paraaortic, and mesenteric lymph nodes for abdominal staging. The operation was performed using four trocars; the splenic vessels were divided by a linear stapler. In general the spleen was removed in a bag through a slightly enlarged trocar incision or after morcellation. Three patients needed a small laparotomy for the removal (laparoscopic assisted). In a recent case of Hodgkin's disease the intact spleen was removed via posterior colpotomy. In 22 of 27 cases (81%) the operation was finished laparoscopically. Five times a conversion to conventional laparotomy was necessary because of bleeding of enlarged lymph nodes at the hilum. Wound infections occurred in two cases. In one patient with ITP the platelet count did not improve and continuous blood loss led to relaparotomy at the 1st postoperative day. No surgical bleeding was found. All patients tolerated a fluid diet at the 1st postoperative day and hospitalization time was 4.4 days (range 3-14). Regarding the low complication rate and the advantages of a smaller abdominal trauma in the postoperative period, the laparoscopic approach for elective splenectomy and laparoscopic abdominal staging has a substantial benefit for the patients.

Adolescent↗
PubMed1994

[Plexiform fibrohistiocytic tumor. Histology, immunohistology and ultrastructure].

An example of a plexiform fibrohistiocytic tumour (PFT) is presented for the first time in the German-language literature. The diagnostic criteria for this rare soft-tissue neoplasm of childhood and young adulthood, which is mostly subcutaneous in location and has a tendency to recur, include the plexiform structure which gives it its name, extensive siderin deposits and numerous osteoclast-like giant cells. The development of the tumour described here, which occurred in the field of radiation of a malignant haemangiopericytoma excised 7 years previously, indicates the possibility of induction of PFT by radiation.

Adipose Tissue↗
PubMed1994

[Colpotomy for specimen removal in laparoscopic surgery].

The removal of the specimen is one of the major problems in laparoscopic colon surgery. In two female patients we have found a solution in the colpotomy. It is easy to perform and hardly recognized by the patient. Other large specimen as a kidney or spleen can also be removed this way. An elongation of an incision in the abdominal wall can be avoided. The pneumoperitoneum is preserved by a special clamp for the extraction via colpotomy. The removal of a specimen via colpotomy is a conclusive step towards, minimal invasive surgery'.

Adult↗
PubMed1994

[Jejunal small intestine duplication].

Duplications of the alimentary tract are rare. Most of them are diagnosed during infancy or childhood, when they become symptomatic and a palpable mass is found. Major complications are bleeding, perforation, ileus and pancreatitis. In the majority of cases the gastro-intestinal duplication is localized in the small bowel. Correct preoperative diagnosis by means of imaging techniques is rare. Because there is no malignancy surgery is only necessary in symptomatic cases.

Adult↗
PubMed1994

[Primary sarcoma of the liver in adults].

Eleven adult patients with primary sarcoma of the liver underwent surgery at the University Hospital of Hamburg-Eppendorf between 1985 and January 1994. In 8 cases it was possible to resect the tumor with wide margins (R0), in 1 of these in the course of orthotopic liver transplantation. Three patients had primarily marginal resection (R1). By the end of the study period 7 of the patients who underwent initial R0 resection are tumor-free, with a mean survival time of 57 (5-104) months. The patient with orthotopic liver transplantation developed metastases 31 months after primary surgery. At 7 months after initial R1 resection, 1 patient is alive with no evidence of disease while 2 others died after 30 and 35 months, respectively. Patients with non-metastasized, primary sarcomas of the liver can expect long-term survival if the tumor is resected with wide margins in an anatomical hepatectomy. In the case of multifocal growth in the liver transplantation can be considered.

Adult↗
PubMed1994

[Limited radical approach in differentiated thyroid gland cancers. A prospective study of 107 patients].

From 1979 until 1987 a prospective study about limited radical therapy of 107 patients with differentiated cancer of the thyroid was performed. Nearly all of the tumors were occult papillary or encapsulated papillary and follicular carcinomas. The thyroid was not completely resected. Postoperative therapy consisted in TSH-suppression. After a follow-up of 7.5 (5-12) years one patient had died because of the tumor disease. Four patients had to be reoperated for lymph node metastases and then stayed free of disease as all other patients.

Adenocarcinoma, Follicular↗
PubMed1993

[Staging laparoscopy in Hodgkin's disease. A valid alternative to staging laparotomy].

A 30-year-old man with Hodgkin's disease, stage IA, had received radiotherapy to the supradiaphragmatic lymph nodes two years ago. During follow-up observations the patient felt well, but sonography revealed three tumours in the spleen. The erythrocyte sedimentation rate was found to be raised to 50/75 mm. Therefore, splenectomy and staging of the other parts of the abdomen for histological clarification and deciding on further therapeutic action were indicated. Thus splenectomy with bilateral liver wedge resections were performed laparoscopically, together with excision of mesenteric, paraaortic and para-iliac lymph nodes. The patient was discharged home on the 4th postoperative day. Histological examination revealed stage IIIE Hodgkin's disease. This case demonstrates that in favourable conditions staging laparoscopy can obtain the same information as conventional staging laparotomy, but it is much better tolerated by the patient.

Adult↗
PubMed1993

[Pneumatosis intestinalis--histology, immunocytochemistry and new theory of morphogenesis].

Based on the light microscopical and immunocytochemical findings in two cases of pneumatosis intestinalis, a new theory is advanced on the morphogenesis of the cysts that can be observed in this disease. The cavities identifiable in both cases in the submucosa of the small intestine and of the colon, respectively, were partially lined by histiocytes and foreign-body giant cells. Most of the lumina found in the subserosa of the stomach, small intestine and colon had an identical aspect. In addition, there were numerous true cysts here with a narrow, single-layered cells seam, showing the immunocytochemical characteristics of the mesothelium, but not the capillary endothelia. Thus, contrary to previous assumptions, pneumatosis interstinalis apparently does not develop from cystic dilatation of gas-filled lymph vessels that shrink and disappear in the process of an inflammatory foreign body reaction. Rather, the disease initially seems to manifest itself through gas-filled pseudocysts partially bordered by histiocytes and foreign-body giant cells, which become secondarily mesothelialized in the subserosa. Lymph vessels would thus not have significance for the morphogenesis of this disease.

Aged↗
PubMed1993

Malignant haemangiopericytoma of the chest wall.

A patient with malignant haemangiopericytoma of the right second rib is described. En-bloc resection of this rare tumour with the adjacent upper lobe of the lung and part of the chest wall could be achieved. The clinical and morphologic features of this case are presented. On account of the high risk of local recurrence and distant metastasis, we think an adjuvant chemo- and radiotherapy is indicated.

Adult↗
PubMed1993

Treatment results obtained in metastatic soft-tissue sarcoma with a combination of doxorubicin and dacarbazine or doxorubicin and ifosfamide.

Between 1982 and 1986, 38 patients with soft-tissue sarcomas were treated with the combination doxorubicin/dacarbazine (group A); between 1986 and 1990, another 46 patients received doxorubicin/ifosfamide (group B); and between 1990 and 1991, 11 patients received an alternating regimen of doxorubicin and ifosfamide (group C). The patients' characteristics were comparable among the three groups. Overall remission rates were 34% in group A, 44% in group B, and 18% in group C. The duration of remission was 10 months and the median survival was 13 months in groups A and B. Toxicity, especially myelotoxicity, was severe, with no marked differences being noted between the groups. We conclude that both doxorubicin/dacarbazine and doxorubicin/ifosfamide are active regimens in metastatic soft-tissue sarcomas; nevertheless, the overall prognosis for these patients remains poor.

Adolescent↗
PubMed1993

[Laparoscopic splenectomy].

From August until October 1992 laparoscopic splenectomy has been performed upon three patients with idiopathic thrombocytopenia. The splenic vessels were divided by an Endo-GIA. The spleen could be removed through a slightly extended trocar-incision. The Idiopathic thrombocytopenia without an enlarged spleen provides a possible indication for laparoscopic surgery.

Adult↗
PubMed1992

[Scapulectomy as an extremity preserving intervention in surgery of soft tissue sarcoma].

In the treatment of soft tissue sarcomas, radical surgery may mean total scapulectomy. If the tumour is localized next to the scapula wide margins can be better achieved by an operation of this kind than by resection of soft parts. In the planning of these operations radical surgery has priority. The functional results after total scapulectomy is acceptable. There is a distinct reduction of shoulder mobility, especially in abduction. As the peripheral joints are fully conserved, the extremity can be used very well in daily life. The indications for total scapulectomy and the technique are discussed with reference to two clinical cases.

Follow-Up Studies↗
PubMed1992

Soft tissue sarcomas of the extremities and trunk in the adult. Report of 124 cases.

Between 1970 and 1988 surgery was performed on 124 patients with soft tissue sarcomas of the extremities and trunk in the University Clinics of Hamburg. Liposarcoma, malignant fibrous histiocytoma, fibrosarcoma and malignant schwannoma were the most common histological types. High-grade sarcomas (G3) predominated, with 41%, while 26% were graded G2 and 33% G1. Resection with wide margins all round was achieved in only 54% of the patients. The quality of the operation proved to be only therapy-related prognostic factor. In addition, tumour grade, size, regional lymph node and distant metastasis and histological type proved to be relevant to the prognosis. With multivariate analysis, distant metastasis, grade, resectability and histological type retained prognostic significance. The efficacy of adjuvant chemo- and radiotherapy was related to the quality of the preceding tumour resection. In case of gross tumour the rate of either partial or complete response was 28% for chemotherapy and 22% for radiotherapy. The mean survival time was 102 months; the 5- and 10-year survival rates were 48% and 37%, respectively.

Adolescent↗
PubMed1992

Does malignant transformation of benign soft-tissue tumours occur? A clinicomorphological study of ten initially misdiagnosed soft-tissue sarcomas.

Ten soft-tissue sarcomas out of a consecutive series of 201 neoplasms are described, in which the clinical histories were suggestive of malignant transformation of a benign lesion excised from the same location 2-97 months before. Each of the 10 preceding soft-tissue neoplasms was reviewed histologically and reclassified as either highly (n = 8) or moderately differentiated (n = 2) sarcomas. Irrespective of the primary treatment, these initially misdiagnosed tumours showed an overall better prognosis than the whole group of soft-tissue sarcomas (5- and 10-year survival rates 76% versus 44%, and 52% versus 30% respectively). Their clinical course was, however, characterized by up to 6 (mean 2.9) local recurrences. From the total series of 201 tumours the authors conclude that soft-tissue sarcomas other than malignant schwannomas in the setting of von Recklinghausen's disease only exceptionally, if ever, arise from benign precursors.

Adult↗