Effect of pantoprazole in tumor bleeding prevention in patients with unresectable gastric cancer: a randomized,double-blind, placebo-controlled clinical trial / 中国综合临床

Objective To investigate the effects of pantoprazole treatment in the prevention of gastric tumor bleeding in patients with unresectable gastric cancer. Methods This study was a prospective double-blind,randomized,placebo-controlled trial. From January 2014 to July 2015,patients with gastric tumor bleeding in Xuzhou Cancer Hospital were included in this study. 131 cases of unresectable gastric cancer were randomly divided into two groups. In the experimental group,66 cases were taken pantoprazole 40 mg,1 time / d,and 65 cases in the control group were given placebo 40 mg and 1 time/ d. The course of treatment was 8 weeks. The differences in tumor bleeding,blood transfusion requirements and overall survival time between the two groups were observed during the follow-up period. Results The median follow-up time was 6. 5 ( 3. 3, 13. 2 ) months. Seven cases ( 10. 61%) in pantoprazole group had tumor bleeding, and 13 ( 20%) in the placebo group. There was no significant difference in cumulative risk of tumor bleeding between the two groups (Gray's test: P = 0. 426) . However,in the first 5 months of follow-up,the cumulative incidence of tumor bleeding in pantoprazole group was 0,lower than that in placebo group (9. 23%) (6/ 65) (Gray's test: P = 0. 039). There was no significant difference in blood transfusion requirement and overall survival between the two groups. No drug-related adverse reactions and bleeding related deaths occurred during the follow-up period. Conclusion Pantoprazole can not significantly reduce tumor bleeding in patients with unresectable gastric cancer.

Glioma Mimicking a Hypertensive Intracerebral Hemorrhage

Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.

An Intracranial Chondroma with Intratumoral Hemorrhage: A Case Report and Review of the Literature

A 55-year-old female presented to the emergency room with a complaint of aphasia. Her initial brain computed tomography scan showed an intracranial hemorrhage in the left frontal area. After surgery, histopathological examination confirmed the diagnosis of a chondroma. Intradural chondroma is a rare, slow growing, benign intracranial neoplasm, but is even rarer in combination with an intratumoral hemorrhage. Chondromas are generally avascular cartilaginous lesions. Our case was thought to be caused by the rupture of abnormally weak vessels derived from the friable tumor. Intradural chondromas may be included in the differential diagnosis of intracranial tumors with acute hemorrhages.

Dermatofibrosarcoma protuberans de cuero cabelludo / Dermatofibrosarcoma protuberans of scalp

El Dermatofibrosarcoma Protuberans (DFSP), es una tumoración poco frecuente, representa del 2 al 6 por ciento de todos los sarcomas de tejido blandos, se considera de origen dérmico. Se caracteriza por ser de una malignidad intermedia, con poca potencialidad metastásica aun que lo puede hacer tardíamente en el desarrollo de la enfermedad, es de crecimiento por lo general lento, localmente agresivo y con altos índices de recurrencia luego de los tratamientos. Mayormente afecta pacientes entre los 20 y 50 años aunque se han descrito casos en niños y ancianos, como es este caso. Se presenta el caso de un paciente de 91 años de edad, con una tumoración localizada en cuero cabelludo, el procedimiento quirúrgico de extirpación el para estudio histopatológico de toda la masa tumoral, que permitió efectuar el diagnóstico de Dermatofibrosarcoma Protuberans. Se discute aspectos clínicos, diagnósticos y terapéuticos de este caso.

Dermatofibrosarcoma Protuberans (DFSP) is a rare tumor, accounts for 2 to 6 per cent of all soft tissue sarcomas, it is considered of dermal origin. It is characterized as intermediate malignancy with low metastaic potencial, it can do even late in the development of the disease, is usually slow growing, locally aggressive with high recurrence rates after treatment. Mainly affects patients between 20 and 50 years although cases, have been reported in children and the elderly, as in this case. A case of a patient 91 years old with a tumor located on the scalp, the surgical procedure of removal for histopathological study of the whole tumor mass, allowed the diagnosis of dermatofibrosarcoma protuberans. We discuss clinical, Diagnostic and therapeutic in this case.

A Case of Oligodendroglioma Presenting as Ventricular Hemorrhage After Head Injury

Oligodendroglioma constitutes about 4% of all gliomas. The usual symptoms of oligodendrogliomas are seizures, focal neurologic deficits, and increased intracranial pressure. They usually present with a gradual onset of symptoms and slow progression. The apopletic symptom due to sudden tumor bleeding is rare. The author review literatures and present a case of oligodendroglioma initially manifested as ventricular hemorrhage after head injury.