Subject(s)
Ablation Techniques/trends , Barrett Esophagus/surgery , COVID-19 , Esophageal Neoplasms/surgery , Esophagectomy/trends , Esophagoscopy/trends , Administrative Claims, Healthcare , Barrett Esophagus/diagnosis , Databases, Factual , Early Detection of Cancer/trends , Esophageal Neoplasms/diagnosis , Humans , Retrospective Studies , Time Factors , United StatesABSTRACT
Adenocarcinoma of the bladder is a rare form of malignancy accounting for fewer than 2% of bladder tumours. It is most commonly a result of direct invasion from prostatic, rectal or gynaecological primaries and less commonly presents from distant haematological or lymphatic metastasis. We report a rare case of oesophageal carcinoma metastasising to the bladder. It involves a 71-year-old man with progressive dysphagia and diagnostic computerised tomography findings of thickening in the oesophagus, bladder and common bile duct. Subsequent endoscopic biopsies of the oesophageal and bladder abnormalities showed immunohistochemical features consistent with upper gastrointestinal malignancy. This report aims to add to current clinical evidence of this route of metastasis and also highlight some of the key markers used by pathologists in interpretation of specimens. It also emphasises the essential role of a multidisciplinary approach for the diagnosis of such rare conditions.
Subject(s)
Adenocarcinoma/pathology , Deglutition Disorders/etiology , Esophageal Neoplasms/pathology , Hydronephrosis/diagnosis , Urinary Bladder Neoplasms/diagnosis , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Adenocarcinoma/therapy , Aged , Biopsy , Cystoscopy , Esophageal Neoplasms/complications , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/therapy , Esophagus/diagnostic imaging , Esophagus/pathology , Humans , Hydronephrosis/etiology , Male , Palliative Care , Terminal Care , Urinary Bladder/diagnostic imaging , Urinary Bladder/pathology , Urinary Bladder Neoplasms/secondary , Urinary Bladder Neoplasms/therapy , Weight LossABSTRACT
We present three patients affected by pulmonary squamous cell carcinoma, metastatic esophageal cancer and advanced non-Hodgkin lymphoma, who incurred in coronavirus 2019 (COVID-19) infection during the early phase of epidemic wave in Italy. All patients presented with fever. Social contact with subject positive for COVID-19 was declared in only one of the three cases. In all cases, laboratory findings showed lymphopenia and elevated C-reactive protein (CRP). Chest x-ray and computed tomography showed bilateral ground-glass opacities, shadowing, interstitial abnormalities, and "crazy paving" pattern which evolved with superimposition of consolidations in one patient. All patients received antiviral therapy based on ritonavir and lopinavir, associated with hydroxychloroquine. Despite treatment, two patients with advanced cancers died after 39 and 17 days of hospitalization, while the patient with lung cancer was dismissed at home, in good conditions.
Subject(s)
Coronavirus Infections/drug therapy , Hydroxychloroquine/therapeutic use , Lopinavir/therapeutic use , Neoplasms/complications , Pneumonia, Viral/drug therapy , Ritonavir/therapeutic use , Aged , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Betacoronavirus , COVID-19 , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/drug therapy , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Disease Outbreaks , Drug Therapy, Combination , Esophageal Neoplasms/complications , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/drug therapy , Fatal Outcome , Humans , Italy , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Lung Neoplasms/drug therapy , Lymphoma, Non-Hodgkin/complications , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/drug therapy , Male , Middle Aged , Neoplasms/diagnosis , Neoplasms/drug therapy , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , SARS-CoV-2 , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Barrett Esophagus/diagnosis , Coronavirus Infections/prevention & control , Delayed Diagnosis , Dyspepsia/diagnosis , Esophageal Neoplasms/diagnosis , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Barrett Esophagus/pathology , Barrett Esophagus/surgery , Betacoronavirus/pathogenicity , Biopsy , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Endoscopic Mucosal Resection , Esophageal Mucosa/diagnostic imaging , Esophageal Mucosa/pathology , Esophageal Mucosa/surgery , Esophageal Neoplasms/pathology , Esophageal Neoplasms/surgery , Humans , Infection Control/standards , Intestinal Mucosa/diagnostic imaging , Intestinal Mucosa/pathology , Male , Metaplasia/diagnostic imaging , Metaplasia/pathology , Metaplasia/surgery , Middle Aged , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2Subject(s)
Barrett Esophagus/diagnosis , Coronavirus Infections/epidemiology , Esophagoscopy , Gastroscopy , Pneumonia, Viral/epidemiology , Surgical Sponges , Triage/methods , Adult , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Deglutition Disorders/etiology , Esophageal Neoplasms/diagnosis , Humans , Middle Aged , Pandemics , SARS-CoV-2 , Stomach Neoplasms/diagnosisABSTRACT
Since December 2019, unexplained pneumonia has appeared in Wuhan City, Hubei Province, and a new type of coronavirus infection was confirmed as COVID-19. COVID-19 spread rapidly nationwide and abroad. The COVID-19 has brought huge impacts to all the people and walks of life, especially to the medical and health systems. It has also brought great challenges to the treatment of patients with cancer. Esophageal cancer is a common malignant tumor in China and most of the patients are in the middle and advanced stage when diagnosed, with immunosuppressive and poor prognosis. The selection of surgical procedures and perioperative managements of esophageal cancer require all thoracic surgeons work together to figure out a reasonable system of surgical treatment and emergency response.