Primary mediastinal pleomorphic rhabdomyosarcoma: a case report

To report a rare case of pleomorphic rhabdomyosarcoma which occurred in the mediastinum of a 34-year-old man. A young male labourer presented with dyspnoea on exertion. A large mediastinal mass was detected on chest CT scan. The chest surgeons advised against open biopsy. His alpha-fetoprotein was 22,000 IU/l; based on this the diagnosis of a germ cell tumour was made and the patient was treated with a bleomycin/etoposide/cisplatin regimen. He left for his native country where an open biopsy from the mediastinum was taken and reported as pleomorphic rhabdomyosarcoma. He was given five courses of chemotherapy with doxorubicin, etoposide, and ifosfamide with mesna protection without much relief. The inoperable disease occupied the whole of the right chest and mediastinum. The enormous size of the radiation field made radiotherapy prohibitive. Finally, the patient opted for symptomatic treatment and left for his native place. This case is presented because of its difficulty in management and rarity

Hodgkin's disease: Kuwait experience

To describe histologic subtypes, clinical presentation and treatment outcome of Hodgkin's lymphoma in Kuwait. Subjects and Method: Patients older than 15 years, diagnosed with Hodgkin's lymphoma between 1980 and 1998, were included in this retrospective analysis. Data were collected using a standardized form that included demographics, histologic subtypes, clinical presentation, stage, extranodal involvement, treatment modality and follow-up. Histology reports were obtained from hospital records. There were 83 [59%] males and 57 [41%] females. Dominant histologic subtypes were nodular sclerosis 65 [46.4%] and mixed cellularity 42 [30%]. Constitutional symptoms were reported by 54 [38.6%] of the cases. Two thirds [64%] of the cases were advanced. Primary extranodular involvement included liver [8%], gastrointestinal tract [7%], lung and bone marrow [4% each]. Disease-free survival according to treatment groups were: radiotherapy alone 100%, chemotherapy alone 88%, and combined modality 65%. The 5-year Kaplan-Meier estimates of overall disease-free survival was 84%. In the cohort of 137 patients with Hodgkin's disease the treatment with combined radiotherapy and chemotherapy had a remarkable outcome. However, evaluation of long-term treatment complications is needed

combination taxol + ifosfamide + mitoxantion in the treatment of advanced breast cancer

In a Phase II study, patients with advanced breast cancer resistant to antracyclines were treated with a combination of Paclitaxel, Ifosfamid and Mitoxantron. Paclitaxel was administered in the dose of 135 mg/m2 by 3 -hour infusion. Altogether 65 cycles in 15 patients were administered, for an overall response rate of 46,6%. The most frequent hematological toxicity was myelosupression, Non-haematological toxicities were never of clinical concern. The combination was found to be useful out patient's treatment in breast cancer patients resistant to antracyclines