Spinal cord compression after radiolabeled metaiodobenzylguanidine analogue therapy in advanced malignant insulinoma.

Malignant insulinomas are frequently diagnosed at a late stage. Medical management is necessary to slow progression of the disease and control of hypoglycemic symptoms when cure by surgical treatment is not possible. Multimodal treatment, in these cases, has been used with variable clinical response. We describe a 68-yr-old woman who presented response failure to usual treatment and was alternatively treated with radiolabeled metaiodobenzylguanidine ([131I]-MIBG) analogue therapy with development of neurologic complications. We also present a review of the current role of [131I]-MIBG treatment in insulinomas.

Spinal cord compression after radiolabeled metaiodobenzylguanidine analogue therapy in advanced malignant insulinoma

Malignant insulinomas are frequently diagnosed at a late stage. Medical management is necessary to slow progression of the disease and control of hypoglycemic symptoms when cure by surgical treatment is not possible. Multimodal treatment, in these cases, has been used with variable clinical response. We describe a 68-yr-old woman who presented response failure to usual treatment and was alternatively treated with radiolabeled metaiodobenzylguanidine ([131I]-MIBG) analogue therapy with development of neurologic complications. We also present a review of the current role of [131I]-MIBG treatment in insulinomas.

Biópsias de lesões pulmonares com agulha grossa guiadas por tomografia computadorizada: a experiência de um centro oncológico / Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

OBJETIVO: O objetivo deste estudo é apresentar a experiência de um centro oncológico com o procedimento de biópsia por agulha grossa de lesões pulmonares guiadas por tomografia computadorizada. MATERIAIS E MÉTODOS: Trata-se de um estudo retrospectivo de 97 biópsias por agulha grossa de lesões pulmonares guiadas por tomografia computadorizada em um centro oncológico, referência no Brasil (Hospital do Câncer - A.C. Camargo), entre os anos de 1996 e 2004. As informações a respeito de material adequado e diagnóstico específico foram coletadas e analisadas. RESULTADOS: Das 97 biópsias pulmonares, 94 (96,9 por cento) forneceram material suficiente para análise histológica, e destas, 71 (73,2 por cento) corresponderam a lesões malignas e 23 (23,7 por cento) corresponderam a lesões benignas. Em três biópsias o material obtido não foi suficiente para análise. A frequência de diagnóstico específico foi de 83 (85,6 por cento) casos, demonstrando elevadas taxas, tanto nas lesões malignas, com 63 (88,7 por cento) casos, como nas lesões benignas, com 20 (86,7 por cento) casos. Considerando as complicações, ocorreram 12 (12,4 por cento) casos no total, divididos em 7 (7,2 por cento) casos de hematoma, 3 (3,1 por cento) casos de pneumotórax e 2 (2,1 por cento) casos de hemoptise. CONCLUSÃO: A biópsia percutânea com agulha grossa de lesões pulmonares guiada por tomografia computadorizada demonstrou elevadas taxas de material adequado e diagnóstico específico e reduzidas taxas de complicações no presente estudo.

OBJECTIVE: The present study is aimed at describing the experience of an oncology center with computed tomographyguided core-needle biopsy of pulmonary lesions. MATERIALS AND METHODS: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Câncer - A.C. Camargo). Informations regarding material appropriateness and the specific diagnoses were collected and analyzed. RESULTS: Among 97 lung biopsies, 94 (96.9 percent) supplied appropriate specimens for histological analyses, with 71 (73.2 percent) cases being diagnosed as malignant lesions and 23 (23.7 percent) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6 percent) cases, with high rates for both malignant lesions with 63 (88.7 percent) cases and benign lesions with 20 (86.7 percent). As regards complications, a total of 12 cases were observed as follows: 7 (7.2 percent) cases of hematoma, 3 (3.1 percent) cases of pneumothorax and 2 (2.1 percent) cases of hemoptysis. CONCLUSION: Computed tomography-guided coreneedle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study.

CT-guided cutting needle biopsy of lung lesions--an effective procedure for adequate material and specific diagnose.

OBJECTIVE: Computed guided percutaneous biopsy of lung lesions is widely accepted as an effective and safe procedure for specific diagnose. The purpose of this study is to present the experience of an oncology center in the use of computed tomography (CT)-guided cutting needle biopsy as an effective procedure for adequate material and specific diagnose of lung lesions. SUBJECTS AND METHODS: This study reports a retrospective analysis of 94 consecutive patients admitted in an oncologic center, reference in Brazil (Hospital do Câncer-AC Camargo), between 1996 and 2004, who were submitted to 97 CT guided cutting needle biopsy of pulmonary lesions. Informations of material adequacy and specific diagnose were studied. RESULTS: In a total of 97 biopsies of lung lesions, 94 (96.9%) supplied adequate material for histological analyses with 71 (73.2%) as malignant lesions and 23 (23.7%) diagnosed as benign lesions and in 3 biopsies the material supplied was inadequate. The frequency of specific diagnosis was higher in both malignant and benign lesions with 63 (88.7%) cases and 20 (86.7%) cases respectively. CONCLUSIONS: CT-guided cutting needle biopsy is an effective procedure for adequate material and specific diagnostic for malignant and benign lung lesions.

Predictive complication factors for CT-guided fine needle aspiration biopsy of pulmonary lesions.

OBJECTIVE: Distinct aspects can influence the complication rates of computed tomography-guided percutaneous fine needle aspiration biopsy of lung lesions. The purpose of the current study is to determine the influence of radiological techniques and clinical characteristics in predicting complications from this procedure. SUBJECTS AND METHODS: A retrospective study was developed involving 340 patients who were submitted to a consecutive series of 362 computed tomography-guided fine needle aspiration biopsies of lung lesions between July 1996 and June 2004, using 22-gauge needles (CHIBA). Variables such as the radiological characteristics of the lesions, secondary pulmonary radiological findings, co-morbidities, and aspects concerning the procedure were studied. RESULTS: The diameters of the lung lesions varied from 9 to 140 mm, with a mean of 51.5 ± 24.3 mm and median of 40mm. The depth of the lesions varied from 10 mm to 130 mm, with a mean of 44 ± 20.9mm, and median median of 52 mm. Complications occurred in 52 (14.4%) cases, pneumothorax being the most frequent, with 40 (11.1%) cases, followed by hemoptisis with 7 (1.9%) cases, and hematoma with 4 (1.1%) cases. Lesions that did not contact the pleura, with normal pulmonary tissue interposition between lesion and pleura, had higher complication rates, with 22 (22%) cases, than lesions that contact the pleura, with 6 (9%) cases, with a statistically significant difference (p = 0.03). CONCLUSIONS: CT-guided percutaneous fine needle aspiration biopsy of lung lesions had a lower rate of complications in our study and presented more rates of complications on lesions that lack pleural contact.

Predictive complication factors for ct-guided fine needle aspiration biopsy of pulmonary lesions

OBJECTIVE: Distinct aspects can influence the complication rates of computed tomography-guided percutaneous fine needle aspiration biopsy of lung lesions. The purpose of the current study is to determine the influence of radiological techniques and clinical characteristics in predicting complications from this procedure. SUBJECTS AND METHODS: A retrospective study was developed involving 340 patients who were submitted to a consecutive series of 362 computed tomography-guided fine needle aspiration biopsies of lung lesions between July 1996 and June 2004, using 22-gauge needles (CHIBA). Variables such as the radiological characteristics of the lesions, secondary pulmonary radiological findings, co-morbidities, and aspects concerning the procedure were studied. RESULTS: The diameters of the lung lesions varied from 9 to 140 mm, with a mean of 51.5 ± 24.3 mm and median of 40mm. The depth of the lesions varied from 10 mm to 130 mm, with a mean of 44 ± 20.9mm, and median median of 52 mm. Complications occurred in 52 (14.4 percent) cases, pneumothorax being the most frequent, with 40 (11.1 percent) cases, followed by hemoptisis with 7 (1.9 percent) cases, and hematoma with 4 (1.1 percent) cases. Lesions that did not contact the pleura, with normal pulmonary tissue interposition between lesion and pleura, had higher complication rates, with 22 (22 percent) cases, than lesions that contact the pleura, with 6 (9 percent) cases, with a statistically significant difference (p = 0.03). CONCLUSIONS: CT-guided percutaneous fine needle aspiration biopsy of lung lesions had a lower rate of complications in our study and presented more rates of complications on lesions that lack pleural contact.