RESUMEN
Papillary-follicular thyroid carcinoma usually remains localized to the thyroid bed and, in cases of metastasis, almost always involves the lung, bone, or liver. The two patients described here presented with papillary carcinoma and neurologic dysfunction. Total body iodine 131 scans disclosed cerebral uptake, and cerebral masses were confirmed by computed tomographic scan. Both patients presented diagnostic and therapeutic dilemmas, and ultimately underwent craniotomy. One patient's cerebral metastasis recurred and was treated by a second craniotomy. The other patient received postoperative external cerebral radiotherapy and a novel intraoperative treatment: implantation of 22 iodine 125 seeds in the tumor bed, estimated to yield 16,000 rad (160 Gy) in one year. To date, cerebral metastases have not recurred in the latter patient, although tumor has reappeared in other sites. There is little reported in the medical literature concerning cerebral metastases of thyroid carcinoma, and the present report reviews this experience and discusses treatment alternatives.
Asunto(s)
Adenocarcinoma/secundario , Neoplasias Encefálicas/secundario , Neoplasias de la Tiroides/patología , Adenocarcinoma/diagnóstico , Adenocarcinoma/terapia , Anciano , Braquiterapia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/terapia , Terapia Combinada , Craneotomía , Humanos , Radioisótopos de Yodo/uso terapéutico , Masculino , Enfermedades del Sistema Nervioso/diagnósticoRESUMEN
Hemangiopericytoma is an uncommon sarcoma arising from the pericapillary cells. While the rarity of this lesion precludes randomized investigation, metastatic hemangiopericytoma has been noted to respond to a variety of agents, including vincristine, adriamycin, actinomycin, and high-dose methotrexate. We wish to report an unusual case of this disease which failed to respond to the above but then exhibited a marked response to dibromodulcitol. In light of the unusual nature of this response, we would like to suggest a controlled trial of the use of dibromodulcitol in patients with this rare tumor.
Asunto(s)
Hemangiopericitoma/tratamiento farmacológico , Neoplasias Pulmonares/secundario , Mitolactol/uso terapéutico , Anciano , Femenino , Hemangiopericitoma/secundario , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Metástasis de la Neoplasia , MusloAsunto(s)
Carcinoma de Células Escamosas/terapia , Recurrencia Local de Neoplasia/terapia , Neoplasias del Cuello Uterino/terapia , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Traumatismos por Radiación/etiología , Remisión Espontánea , Factores de TiempoAsunto(s)
Carcinoma/radioterapia , Histerectomía , Complicaciones Posoperatorias/radioterapia , Neoplasias del Cuello Uterino/radioterapia , Adenocarcinoma/patología , Adenocarcinoma/radioterapia , Adulto , Anciano , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias del Cuello Uterino/patologíaRESUMEN
Between 1961 and 1974, 51 women with primary carcinoma of the breast were treated by external radiation following surgery that was limited to diagnostic biopsy. All patients tolerated therapy well with minimal long term morbidity. While the reported follow-up periods are brief (most patients at risk for less than 3 years), 29 patients remain alive, 25 of whom show no evidence of persistent or recurring disease. These data suggest that local-regional control rates match those obtained following mastectomy. Definitive statements as to local failures and long term survival rates are not yet available.