RESUMEN
We report a 62-year-old man with symptomatic metastasis to the pleural cavity and the bone marrow from a supratentorial oligoastrocytoma grade III, 24 years after the initial symptoms. Before tumor dissemination, the patient underwent brain surgery four times in 5 years. Six months after the last treatment, extraneural dissemination to the right pleural cavity was discovered. Despite resection of the pleural metastasis, local and distant spread to the bone marrow developed. The patient died 5 months after the occurrence of extraneural tumor metastasis. It is speculated that repeated brain surgery and extended survival may promote extraneural dissemination of supratentorial oligoastrocytoma grade III.
Asunto(s)
Astrocitoma/secundario , Neoplasias de la Médula Ósea/secundario , Neoplasias Pleurales/secundario , Neoplasias Supratentoriales/patología , Astrocitoma/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pleurales/diagnóstico por imagen , Neoplasias Supratentoriales/diagnóstico por imagen , Tomografía Computarizada por Rayos XAsunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Desoxicitidina/análogos & derivados , Síndrome Hemolítico-Urémico/inducido químicamente , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Desoxicitidina/efectos adversos , Síndrome Hemolítico-Urémico/complicaciones , Síndrome Hemolítico-Urémico/patología , Humanos , Riñón/efectos de los fármacos , Riñón/patología , Fallo Renal Crónico/inducido químicamente , Neoplasias Pulmonares/tratamiento farmacológico , Masculino , Persona de Mediana Edad , GemcitabinaAsunto(s)
Glomerulonefritis/inmunología , Enfermedades Renales/inmunología , Hepatopatías/inmunología , Sarcoidosis/inmunología , Anticuerpos Anticitoplasma de Neutrófilos/análisis , Calcio/sangre , Glomerulonefritis/complicaciones , Humanos , Enfermedades Renales/complicaciones , Hepatopatías/complicaciones , Masculino , Persona de Mediana Edad , Sarcoidosis/complicacionesAsunto(s)
Ciclosporina/uso terapéutico , Vasculitis por IgA/complicaciones , Vasculitis por IgA/tratamiento farmacológico , Inmunosupresores/uso terapéutico , Síndrome Nefrótico/tratamiento farmacológico , Síndrome Nefrótico/etiología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Enalapril/uso terapéutico , Inhibidores Enzimáticos/uso terapéutico , Humanos , Hidroximetilglutaril-CoA Reductasas , Lovastatina/uso terapéutico , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Síndrome Nefrótico/patología , Plasmaféresis , Prednisona/uso terapéutico , Proteinuria/complicaciones , Proteinuria/tratamiento farmacológicoRESUMEN
Successful cytogenetic analysis was performed on tumor material from 26 patients with resectable colorectal cancer. 9 women and 17 men, aged 43 to 92 years, median 67 years. Clonal anomalies were found in twenty patients; five tumors showed mainly slight numerical changes such as trisomy 7 and loss of Y (2 cases). The remaining 15 tumors had highly complex karyotypes. The mainline was near diploid in six cases (5/6 tumors of the proximal colon), near triploid in four and near tetraploid in five tumors. Loss of chromosomes was most frequently observed with chromosomes 2, 5, 18, 20, and Y, the most frequently gained chromosomes were 7, 8, 13, 15, and X. Structural aberrations affected all chromosomes, except Y. The most frequently rearranged bands were 5q21, 7p15, 9p21, 13q11, 16p12, 17p13, 18q21, 21q11. Anomalies of chromosomes 5, 17, and 18 occurred concomitantly in 9/20 patients. All patients with deletions of 17p (n = 6) had near tetraploid karyotypes with high cell to cell variability and a median of nine structural aberrations (p < 0.007); four of them presented with parenchymal metastases at the time of surgery. Tumors of the proximal part of colon were with one exception diploid or near diploid, but no specific pattern of aberrations was detectable. However, it appears noteworthy that of the six patients with tumors of the ascending colon, three tumors had deletions at 16p12 and the affected patients had a short duration of survival. The tumor karyotypes of patients with parenchymal metastases revealed a trend to greater complexity of numerical and structural aberrations. Changes involving 8p22 or loss of chromosomes 8 were found in tumors of all parts of the colon and potentially associated with an unfavorable prognosis (4/7 decreased patients showed such changes).