ABSTRACT
The presence of sarcomatous element transforms the usually innocuous spermatocytic seminoma into a highly aggressive neoplasm. We report a case of spermatocytic seminoma with undifferentiated sarcomatous component in a 43-year-old male, presented with testicular mass since two and a half years. Orchidectomy was performed and after 9 months, the patient presented with recurrent scrotal mass with bilateral pulmonary metastases.
Subject(s)
Adult , Antigens, Neoplasm , Histocytochemistry , Humans , Immunohistochemistry , Lung Neoplasms/diagnosis , Lung Neoplasms/secondary , Male , Microscopy , Orchiectomy , Recurrence , Sarcoma/complications , Sarcoma/diagnosis , Sarcoma/pathology , Sarcoma/surgery , Seminoma/complications , Seminoma/diagnosis , Seminoma/pathology , Seminoma/surgery , Testicular Neoplasms/diagnosis , Testicular Neoplasms/pathology , Testicular Neoplasms/surgery , Vimentin/analysisSubject(s)
Ependymoma/diagnosis , Ependymoma/pathology , Ependymoma/surgery , Giant Cell Tumors/diagnosis , Giant Cell Tumors/pathology , Giant Cell Tumors/surgery , Histocytochemistry , Humans , Immunohistochemistry , Magnetic Resonance Imaging , Male , Middle Aged , Spinal Cord/pathology , Spinal Cord/diagnostic imaging , Spinal Cord Neoplasms/diagnosis , Spinal Cord Neoplasms/pathology , Spinal Cord Neoplasms/surgeryABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the effects of oral Sildenafil for treatment of pulmonary hypertension secondary to congenital heart diseases. METHODS & RESULTS: Twelve patients with un-repaired congenital heart diseases resulting in significant pulmonary hypertension were enrolled in a prospective trial of oral Sildenafil treatment for 12 weeks. The outcomes measured were change in the systemic oxygen saturations, 6-minute walk test distance, and New York Heart Association class. The systemic blood pressure and visual symptoms were monitored for evaluating the tolerability of Sildenafil. The mean age was 25.7+/-14.4 years. The mean pulmonary vascular resistance before treatment was 17.4 Wood units. After 12 weeks of sildenafil, an increase in oxygen saturations (87.8+/-5.3%-90.25+/-4%, p=0.04) with an associated increase of one New York Heart Association class (p=0.009) was noted. A non-statistically significant increase in the 6-minute walk test distance (310.33+/-42-333.75+/-54.6 meters, p=0.47) was also noted. Sildenafil was well-tolerated with no significant change in systemic blood pressure or visual side-effects. CONCLUSION: Oral Sildenafil is well-tolerated and produces some improvement in the oxygenation and functional status of patients with pulmonary hypertension secondary to congenital heart diseases.