ABSTRACT
PURPOSE: Recent studies have shown the benefits of the use of methotrexate, vinblastine, doxorubicin and cisplatin(M-VAC) in the treatment of advanced transitional cell carcinoma of the bladder. Although the overall and complete response rates and survival is improved from the use of M-VAC, more than 90% of the patients with metastatic disease still die of the disease, with a median survival of approximately 1 year. MATERIALS AND METHODS: To evaulate the long-term results of M-VAC chemotherapy, we reviewed 51 patients with advanced transitional cell carcinoma of the bladder who were treated with standard dose M-VAC(30mg/m2 methotrexate on day 1, 15, and 22, 3mg/m2 vinblastine on day 3, 15, and 22, 30mg/m2 doxorubicin on day 3 and 70mg/m2 cisplatin on day 2). There were 43 men and 8 women. The age of the patients ranged from 31 to 74 years(mean 60.8) and the duration of follow up ranged from 2.4 to 79.5 months(mean 23.8). RESULTS: Of the 51 patients, 10(19.6%) had a complete and 15(29.4%) had a partial response, giving an overall response rate of 49%. The median duration of response was 11.2 months for the 10 patients with a complete response and of these, eight relapsed at a median of 10.4 months after complete response. Survival of patients with a complete response differed significantly from those with no response at 1 year after the start of treatment, but not subsequently. Toxicity included moderated to severe myelosuppression that resulted in sepsis in 2 patients and mild to moderate anorexia, vomiting, alopecia and renal dysfunction. CONCLUSIONS: Long-term follow up revealed a high relapse rate and poor prognosis in patients with a complete response who received the M-VAC as induction therapy. Therefore, more effective new adjunctive regimens are needed for patients with locally unresectable or metastatic transitional cell carcinoma.
Subject(s)
Female , Humans , Male , Alopecia , Anorexia , Carcinoma, Transitional Cell , Cisplatin , Doxorubicin , Drug Therapy , Follow-Up Studies , Methotrexate , Prognosis , Recurrence , Sepsis , Urinary Bladder , Vinblastine , VomitingABSTRACT
Hemangiomas of the genitalia are extremely rare. A hemangioma is self-limited and usually resolves spontaneously, therefore conservative treatment is generally recommended. However, genital hemangiomas may require surgical treatment for either functional or cosmetic problems. Herein we report a case of cavernous hemangioma of the dorsum of the penis In 36 year old man which was treated with surgical excision.
Subject(s)
Adult , Humans , Male , Genitalia , Hemangioma , Hemangioma, Cavernous , PenisABSTRACT
We present four cases of the recently characterized chromophobe cell renal carcinoma. Gross hematuria, palpable flank mass and flank pain were the main symptoms of patients. With chromophobe cell renal carcinoma all tumors were solitary pale brown or beige colored mass, ranging from 6.0 to 10.5cm in diameter. Microscopically two cases were typical type and the other two cases were eosiophilic type. All of them showed strong reactivity for Hale's colloidal iron stain, cytokeratin and epithelial membrane antigen, but negative for vimentin. Ultrastructually characteristic invaginated microvesicles, 180-440nm in diameter, were identified in the cytoplasm. DNA ploidy studies revealed an aneuploid cell population in two cases of eosinophilic type. No patients showed recurrent tumor during the follow up periods, ranging from 5 to 92months.