[On an unusual remission of pancreatic carcinoma with bone and omental metastases].
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A cell line, established from a neuroblastoma patient, expresses NCAM and L1 cell adhesion molecules. Two chromosomal abnormalities were present in bone marrow (10%) and cell line (82%) metaphases: (i) a homogeneously staining region (HSR) at the distal part of chromosome 14, and (ii) an insertion of unidentified dark G-banding material in 1 p36. The identification in the patient of chr 14-HSR-positive tumour cells, before the in vitro adaptation, suggests a direct HSR formation without preceding double minutes (dms; or a very early in vivo dms----HSR transformation). N-myc was amplified in the HSR. Cells expressed proopiomelanocortin and corticotropin releasing factor mRNAs. Untreated cells were relatively differentiated; nevertheless they dramatically responded to retinoic acid, forming extensive neurites, growth-cones, cell-cell and cell-neurite junctions. Neurofilaments and synaptic figures containing many dense core granules were identified. This differentiation was irreversible. This cell line is therefore useful for the study of differentiation and in particular for the involvement of neurohormones in the differentiation process.
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This literature review highlights the surgical management of recurrent urological malignancies after primary ablative therapy. In particular, recurrent nonseminomatous germ cell tumours (NSGCT) post-chemotherapy, recurrent bladder cancer post-cystectomy, loco-regional recurrence of prostate cancer after radiotherapy, and loco-regional recurrence of renal cell carcinoma after radical nephrectomy. The indications, operative technique, complications and outcomes of each malignancy are discussed.
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Lymphangiomas are rare benign tumours of the lymphatic system and are mostly manifested in the ENT region. The authors describe a rare localisation of this disease originating in the left lower extremity and extending into the retroperitoneum and mediastinum in a 16-year old female patient. MR enabled the diagnosis and the exact determination of the extent. MR follow-up showed 1 1/2 years after the diagnosis that the lymphangiomas and the lymphangioma in the left thigh had reduced and that the proliferation of lymphangioma in the retroperitoneum and mediastinum had stagnated.
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We report a case of retroperitoneal liposarcoma. A 66-year-old male was referred to our hospital for a retroperitoneal tumor that was detected during gallbladder stone examination. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an extrarenal lipomatous tumor, 20 x 14 x 8 cm in size, in the right retroperitoneal space. He underwent surgical excision of the tumor with concomitant resection of the right kidney and adrenal gland. The resected tissue weighed 730 g. Histological examination revealed a well differentiated liposarcoma. He received no adjuvant therapy.
Liposarcomas are malignant mesenchymatous tumors developed from elements constituting the greasy tissue in various stages of differentiation. It is one of the most frequent mesenchymatous sarcomas. Retro-peritoneum is a privileged site of development in 12 to 15% of cases. During 9 years, from 1994 till 2002, we have colligated and operated 5 cases of retro-peritoneal liposarcomas. Average age was 50 years (extremes 34 to 79 years) with a sex-ratio of 1.5. Diagnosis was late beyond 6 months. Abdominal pain and the appearance of an enormous mass (20 cm) were the revealing signs. No imagery method allowed to evoke the diagnosis. The cyto-puncture realized once, was not able to determine with precision the histological type. Immunohistochimy occupies nowadays an important place to classify a sarcoma. Large surgical resection realized in 5 cases did not allowed the complete ablation of the tumour in 3 cases considering the advanced loco-regional extension, which was at the origin of 3 recurrences. Well differentiated histological type was noted in 3 cases, myxoid type in a case and not differentiated type in a case.
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AIM: The objective of this study was to evaluate the utility of CD34-positive peripheral blood stem cell transplantation (PBSCT) in the hematopoietic recovery, in patients receiving high-dose chemotherapy (HDCT), for advanced germ cell tumor (GCT). MATERIALS AND METHODS: This study included 41 patients with advanced GCT, who were treated with HTCT combined with PBSCT. PBSCs were harvested after conditioning chemotherapy followed by the administration of granulocyte colony-stimulating factor. A retrospective analysis of a total of 86 PBSCTs was carried out focusing on the effects of several factors, including age (<35 years versus > or = 35 years), CD34-positive cell dose (<5.0 x10(6)/kg versus > or =5.0 x10(6)/kg), indication of HDCT (first-line versus salvage) and previous history of HDCT before PBSCT (with versus without), on hematopoietic recovery after PBSCT. RESULTS: The median number of CD34-positive PBSCs collected during a single apheresis and the median cumulative number of CD34-positive PBSCs from each patient were 8.3x10(6)/kg and 23.2x10(6)/kg, respectively. The median number of PBSCT performed in each patient was two and the median number of CD34-positive cells transplanted during a single course was 5.7x10(6)/kg. The median recovery times to white blood cells (WBC) greater than 500/microl, 1000/microl and 2000/microl were 8, 9 and 10 days, respectively, following PBSCT, while that to neutrophils greater than 500/microl and that to platelets greater than 50000/microl were 9 and 13 days, respectively, following PBSCT Only the recovery time to platelet count greater than 50000/microl was significantly affected by age; however, there were no significant differences in the recovery of WBC, neutrophils and platelets in relation to several parameters examined. CONCLUSION: These findings suggest that CD34-positive PBSCT may facilitate stable hematopoietic recovery after HDCT in patients with advanced GCT, and that HDCT, if combined with PBSCT, could be performed with comparative safety in such patients, irrespective of their individual characteristics.
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Twelve of 12,125 patients who had been referred during a seven-year period to a specialist in spinal disorders were found to have an extraspinal cause of radiculopathy or neuropathy of the lower extremity. The records of these twelve patients were reviewed retrospectively. The average age of the twelve patients was sixty-five years (range, forty-two to seventy-seven years). The cause of the symptoms was an occult malignant tumor in nine patients and a hematoma, an aneurysm of the obturator artery, or a neurilemoma of the sciatic nerve in the others. The average time from the onset of symptoms to the final diagnosis was eight months (range, one month to two years). The most useful test for determination of the correct diagnosis was computed tomography or magnetic resonance imaging of the abdomen and pelvis. Computed tomography or magnetic resonance imaging of the spine and bone-scanning of the whole body were of little help in localizing the disease. In four of the twelve patients, an operation was performed on the basis of an incorrect diagnosis. In dealing with elderly patients who have radiculopathy, one should be suspicious that the cause is outside the spine.