Thyroid screening program; follow-up evaluation.
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Adolescent↗
Biomedical subjects
U Rao
Publications and source records attributed to U Rao.
Necropsy of a cadaver containing 50 mCi of sodium131 iodide.
A patient who received an oral dose of iodine-131 for the treatment of metastatic thyroid carcinoma unexpectedly died with a large total-body retention of the radioiodine. An autopsy was required and the family requested the body to be transported out of state to their home town. Since the radiation intensity near the surface of the cadaver was above 200 mR/hr, advanced planning and special precautions were necessary in order for the autopsy to proceed safely. This required the immediate cooperation of the pathologists, nuclear medicine physicians, health physicists, an endocrine oncologist, and other hospital staff. As a result of team efforts, personnel radiation exposures were kept as low as reasonably achievable, contamination of the autopsy room was minimal, and the radiation level of the cadaver was adequately reduced for safe transport and burial.
Adult↗
Renal cell carcinoma metastatic to skeletal muscle mass: a case report.
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Adenocarcinoma↗
Interstitial pneumonitis associated with mitomycin C and DTIC: a case report.
A case of interstitial pneumonitis secondary to mitomycin C and DTIC combination therapy in a 58-year-old male with metastatic adenocarcinoma of the rectum is reported. Dry cough and dyspnea, especially on exertion, were presenting symptoms. Arterial blood gas analysis was compatible with severe impairment in pulmonary diffusion capacity. Chest x-ray showed a diffuse increase in interstitial markings in both lung fields consistent with interstitial pneumonia. Histologically, prominence of type I pneumocytes, focal proliferation of type II pneumocytes, and varying degree of fibroblastic proliferation and collagenization within the alveolar septae were observed. The obliteration of alveolar septal vessels due to endothelial edema and/or proliferation of fibroblast-like mesenchymal cells were also noted. Withdrawal of drugs and institution of high dose corticosteroid therapy were followed in rapid improvement in dyspnea and arterial blood gas findings. If diagnosed early, this potentially life threatening complication may respond to such therapy.
Adenocarcinoma↗
Bronchio-alveolar carcinoma. A clinical overview and bibliography.
Clinical aspects of bronchio-alveolar carcinoma are reviewed through over 1,000 cases abstracted from the literature and 58 new cases. This form of lung carcinoma is more equally distributed among the sexes than other forms, and has a better prognosis when diagnosed early. Suggestions that the tumor has a multicentric origin are seen to have arisen from early experience with advanced cases.
Adenocarcinoma↗
Axillary node dissection in malignant melanoma.
Axillary node dissection for nonmammary malignant lesions can be performed easily through an incision in the medial wall of the axilla. In patients with clinical involvement of the axilla with melanoma, positive nodes above the level of the axillary vein may occasionally be found.
Axilla↗
High-dose methotrexate as secondary chemotherapy in metastatic soft-tissue sarcomas.
High-dose methotrexate in a dose of 2-4 g/m2 every four weeks was given as secondary chemotherapy to 22 patients with metastatic soft-tissue sarcoma; toxic reactions included 1 death and 2 instances of moderate hematopoietic toxicity. The remaining patients tolerated this treatment without difficulty. Of 18 patients with measurable evaluable disease, 17 demonstrated progression. One patient with metastatic angiosarcoma had a complete response lasting for 15 months. Three patients were given adjuvant high-dose methotrexate following wedge resections of pulmonary metastases. One patient demonstrated recurrence after four months, another after 13 months, and the third after 15 months. One additional patient underwent resection of pulmonary metastases following two months of stabilization with high-dose methotrexate and has continued free of disease with high-dose methotrexate as adjuvant for eight months. Five patients are alive and have been disease-free for an average period of 14 months. Four of these underwent operative treatment combined with chemotherapy. The effectiveness of high-dose methotrexate appears limited in soft-tissue sarcomas when it is given as secondary chemotherapy.
Adolescent↗
Treatment of adult neuroblastoma.
Twelve patients, all over 17 years of age, with adult neuroblastomas, an entity recently described, were seen at Roswell Park Memorial Institute for the period from 1950 to 1977. Four of these patients who were treated by multimodality therapy constitute the bulk of this report. One patient had a complete response and showed no evidence of disease 23 months after treatment with surgery and combination chemotherapy (CYVADIC); she also had maturation of established metastases. Another patient remained stable for 22 months after treatment with combination chemotherapy. These results indicate that chemotherapy may be effective treating adult neuroblastoma patients as complete remissions are achieved and survival times prolonged.
Adolescent↗
Intraarterial adriamycin in the treatment of soft tissue sarcomas.
Ten patients with extremity sarcomas adriamycin 60 mg/M2 into the artery supplying the area of tumor. There were minimal local side effects consisting of occasional local erythema or slight transitory pain. Nine of these patients had subsequent surgery, and an average 32.86% histologic tumor necrosis was recorded in the peripherally viable areas of seven patients with residual tumor, compared to a 5.71% necrosis recorded in the biopsy sections (P value less than 0.01).
Adult↗
Radiation-associated thyroid carcinoma.
Since February, 1977, 735 patients having a history of receiving radiation therapy for benign conditions of the head and neck areas during infancy and childhood were examined in a thyroid screening program, and 159 patients were found to have palpable thyroid nodules. These patients had thyroid function tests and indirect laryngoscopy and were followed closely on suppression therapy consisting of either Cytomel or thyroid extract. Thyroidectomy was advised in those in whom the nodules persisted or increased in size. This study documents the incidence of carcinoma and other benign pathological changes and postoperative complications in this group of patients. So far, 49 patients had either a lobectomy with isthmusectomy or a total thyroidectomy. Eleven patients were found to have carcinoma (six had papillary, four had mixed papillary and follicular, and one had follicular carcinoma). Three patients had a therapeutic modified neck dissection following the documentation of microscopic involvement of paratracheal lymph nodes. A high incidence of chronic nonspecific thyroiditis, postradiation fibrosis, and follicular adenomas were also found in these patients. Three patients had temporary hypocalcemia (two weeks) and none had wound infection, hematoma, or postoperative nerve palsy. Of patients who had surgical resection, 22.4% showed thyroid carcinoma.
Adolescent↗
Suppressive therapy for postirradiation thyroid nodules.
From the thyroid screening program at the Roswell Park Memorial Institute in Buffalo, New York, 85 patients with thyroid nodules who had received previous irradiation to the head and neck were identified. The diagnosis was confirmed microscopically by needle aspiration cytology and the patients were treated with thyroid replacement therapy. In 24 patients, the nodules disappeared completely; a partial response (more than 50% reduction in size) was seen in 26; 11 patients were improved (20% to 50% reduction in size); 14 had stable disease (less than 20% reduction in nodule size) and in 10 the condition progressed (an increase of more than 20% in nodule size). Six of 21 patients who underwent operation had well differentiated tumours. The number of cases of Hashimoto's thyroiditis (14) was high. Suppressive therapy will separate those patients whose nodules will disappear completely and who will thus be spared operation. Continued follow-up of such patients is essential. All other patients should be offered operation since thyroid nodules are malignant in 30% of cases.
Adenocarcinoma↗
Carcinoma of the thyroid gland.
Thyroid cancer is not a common cancer and consists of a variety of tumors with different biological characteristics. Diagnosis and therapeutic approaches differ considerably, depending on which subgroup the tumor belongs to. Differentiated carcinomas, which constitute the bulk of thyroid carcinoma, often retain the features of the thyroid gland, which can be taken advantage of in their management. The prognosis of these patients is usually excellent. Undifferentiated carcinoma, in contrast, is an aggressive tumor and usually is fatal within a year from the diagnosis. Therefore, an aggressive therapeutic approach is required. Transformation of differentiated carcinoma to undifferentiated carcinoma does occur, although infrequently. The importance of proper management of patients with differentiated carcinoma is obvious. Medullary carcinoma, which originates from the parafollicular cells, has various interesting biological characteristics and is a medium-grade malignancy.
Adenocarcinoma↗
Disparity of radioiodine and radiothallium concentrations in chronic thyroiditis.
Three cases of chronic thyroiditis (Hashimoto's disease) presented with thyroid nodules, showed disparate uptakes of radioiodine and radiothallium. All patients were clinically euthyroid and had positive antithyroid antibody titers. On cytological and/or pathological examinations, they were consistent with chronic thyroiditis.
Adult↗
Anaplastic carcinoma of the thyroid following external irradiation.
Two patients with anaplastic carcinoma of the thyroid following irradiation for Hodgkin's disease are presented, and the previously reported cases briefly reviewed. The risk of late development of thyroid carcinoma is life-long and high-dose irradiation in patients with prolonged life expectancy may result in anaplastic carcinoma as well as less malignant histological forms.
Adult↗
Extraosseous osteogenic sarcoma: case report.
Extraosseous osteogenic sarcoma is a highly malignant tumor, and in order to improve the chances of survival of those who have it, aggressive surgical treatment, including major amputations, should be performed. Based on the results obtained in the treatment of its osseous counterpart, the use of adjuvant chemotherapy is strongly recommended. Evaluation should not be done because it is usually followed by local recurrence.
Adult↗
Soft-tissue sarcoma: trends in treatment.
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Adult↗
Anaplastic carcinoma of thyroid: radiation-associated.
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Carcinoma↗
Lymphocytic infiltration in murine tumors.
Histologic grading of the histiolymphocytic reaction in nodules of T241 or B16 murine tumors in 94 C57BL/6J mice was performed at various time intervals post-inoculation. The infiltrate occurring in the first four days was generally sparse and no significant difference was observed between two different dose control inocula, suggesting a weak primary localization. Comparison between control inocula, and challenge inocula in mice harboring the same tumor for 10 days, showed a somewhat denser infiltrate initially in the challenge inocula. Despite the immunogenicity of these tumors, as shown by concomitant immunity, lymphocytic infiltration was generally sparse, consistent with an hypothesis of deficient localization of immunocompetent cells at tumor sites.
Animals↗