ABSTRACT
Papillary thyroid carcinoma is the most common type of thyroid cancer. It is estimated that 4% to 20% of patients with papillary carcinoma will develop distant metastases during the course of their disease, most commonly to lung and bones. We describe the rare occurrence of metastatic papillary carcinoma of the thyroid to the kidney in a living patient that was successfully treated with a right radical nephrectomy and 131I with complete disappearance of all metastatic disease.
Subject(s)
Carcinoma, Papillary/secondary , Kidney Neoplasms/secondary , Thyroid Neoplasms/pathology , Carcinoma, Papillary/therapy , Combined Modality Therapy , Humans , Iodine Radioisotopes/therapeutic use , Kidney Neoplasms/therapy , Male , Middle Aged , NephrectomyABSTRACT
This study was conducted to analyze the effect of different doses of cyclophosphamide (CY) on the lymphocyte populations in the rat. Monoclonal antibodies against rat determinants were used: W3/13 (T lymphocytes), W3/25 (T helper), OX-8 (non-helper), and OX-33 (B lymphocytes). Blood samples were collected on days 0, 3, 7, and 14 from four groups of F-344 Fisher rats (n = 4): three that received 25, 50, or 75 mg/kg of CY and a control group. The duration and severity of lymphocyte depletion were dose-related and were evident for both helper and non-helper cells (p less than 0.02). The helper-to-non-helper ratio increased for the group that received 25 mg/kg when compared with control and other groups, but was only significantly changed when compared with the 75 mg/kg group (p = 0.004). This effect was transitory and was only seen on day 3. The control and the 25 mg/kg groups gained weight; the other two groups lost weight (p less than 0.05). Lower doses of CY were associated with a transitory immunostimulatory effect and no morbidity when compared with higher doses.
Subject(s)
Adjuvants, Immunologic/pharmacology , Cyclophosphamide/pharmacology , T-Lymphocytes, Helper-Inducer/drug effects , Adjuvants, Immunologic/toxicity , Animals , Antibodies, Monoclonal , Body Weight/drug effects , Cyclophosphamide/toxicity , Hematocrit , Hematologic Diseases/chemically induced , Hemoglobins/analysis , In Vitro Techniques , Leukocyte Count/drug effects , Lymphocytes , Platelet Count/drug effects , Rats , Rats, Inbred F344ABSTRACT
From January 1986 to December 1987, 32 patients with recurrent colorectal cancer had second-look radioimmunoguided surgery (RIGS system). All patients had pathologic confirmation of recurrence. The RIGS system identified 81% of recurrences, and in six patients recurrent tumor was identified only by RIGS. All patients had physical examination, carcinoembryonic antigen (CEA) assay, and computerized tomography of the abdomen and pelvis. Detection of recurrence was based on symptoms in six, elevated CEA value in 25, and physical examination in one. The CEA was elevated preoperatively in 30 patients; two false-negative results occurred in symptomatic patients who had pelvic recurrence. The median CEA value in those with liver recurrence was 30 ng/ml (range 5.2 to 298) and for pelvic recurrence 13 ng/ml (range 1.9 to 31) (P less than .05). The overall sensitivity of CT was 41% (abdomen other than liver 37%, liver 56%, and pelvis 22%). The combination of elevated CEA, symptoms, and physical findings identified 100% of recurrences. We conclude that a rising CEA remains the most accurate indicator of recurrence. CT should not be done routinely to detect recurrent colorectal cancer unless CEA is elevated or the patient is symptomatic. In our study the intraoperative use of the RIGS system aided the surgeon in identifying occult tumors.
