ABSTRACT
The authors report a case of 84-year-old women, with dysphagia to liquids and solid foods, and with infiltration of right stemocleidomastoid muscle that compressed the upper third of the esophagus to the thoracic hull. The biopsy of sternocleidomastoid muscle permitted the diagnosis of metastatic breast cancer relapse after 22 years.
Subject(s)
Breast Neoplasms/secondary , Carcinoma, Ductal, Breast/diagnosis , Carcinoma, Ductal, Breast/secondary , Muscle Neoplasms/diagnosis , Muscle Neoplasms/secondary , Muscle, Skeletal , Aged, 80 and over , Deglutition Disorders/etiology , Female , HumansABSTRACT
The authors report a case of women, 51-year-old that presented with peritoneal tuberculosis, with concomitant adrenocortical primitive neoplasm, mistaken as peritoneal carcinomatosis, due to the failure of correct histological analysis. In fact, the critical life status, associated to increases of CA 125, typical imaging of peritoneal carcinomatosis, and presence of 75% atypical cells in ascitic fluid, induced to begin chemotherapy.
Subject(s)
Adrenal Gland Neoplasms/diagnosis , Peritonitis, Tuberculous/diagnosis , Adrenal Gland Neoplasms/pathology , CA-125 Antigen/blood , Colorectal Neoplasms/diagnosis , Diagnosis, Differential , Female , Humans , Middle Aged , Peritoneal Neoplasms/diagnosis , Peritonitis, Tuberculous/pathologyABSTRACT
BACKGROUND: The aim of our study was to determine whether the presence of bone metastases affects outcomes in patients with metastatic clear-cell renal cell carcinoma (m-ccRCC) receiving sunitinib. PATIENTS AND METHODS: We reviewed the charts of all patients in four academic centers in Belgium and France who started first-line sunitinib (50 mg/day; 4 weeks on and 2 weeks off) between January 2005 and December 2008. Data were collected on known prognostic factors for metastatic renal cell carcinoma and metastatic sites. Response and progression were evaluated by computed tomography scan (according to RECIST). RESULTS: Two hundred twenty-three patients were identified. With a median follow-up of 40 months, median progression-free survival (PFS) and median overall survival (OS) were significantly shorter in patients with bone metastases than in those without: respectively, 8.2 versus 19.1 months (P<0.0001) and 19.5 versus 38.5 months (P<0.0001). On multivariate analysis, taking on account platelet count, Eastern Cooperative Oncology Group performance status, number of metastatic sites, neutrophil count, corrected serum calcium, time from diagnosis to systemic treatment, and the presence of bone metastases, bone metastasis was the independent variable most significantly associated with poor PFS (P<0.0001) and OS (P=0.001). CONCLUSION: The presence of bone metastases in m-ccRCC patients has a significant and clinically relevant negative impact on outcome on sunitinib.
Subject(s)
Bone Neoplasms/drug therapy , Carcinoma, Renal Cell/drug therapy , Indoles/therapeutic use , Kidney Neoplasms/drug therapy , Pyrroles/therapeutic use , Bone Neoplasms/secondary , Carcinoma, Renal Cell/pathology , Disease Progression , Disease-Free Survival , Female , Humans , Kidney Neoplasms/pathology , Male , Retrospective Studies , Sunitinib , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Renal cell carcinoma accounts for approximately 3% of all human malignancies. The use of cytokines in metastatic stage of disease has been the standard until last decades, presenting partial and short duration responses. Research on angiogenesis in renal carcinoma has brought important advances to understand tumor biology and to allow us development of new antiangiogenic drugs. Sunitinib (SUTENT), sorafenib (NEXAVAR) and bevacizumab (AVASTIN) are actually three molecules accepted to use in metastatic renal cell carcinoma (mRCC), with a good tolerability demonstrated in different studies. Clinical evidence shows sunitinib to be reference standard of care for the first-line treatment of mRCC. The use of bevacizumab in combination with interferon alfa (IFN alfa) can also be considered in this setting. Sorafenib is recommended for second-line treatment in cytokine-refractory patients, sunitinib being also accepted in this situation. Other combination of these molecules and their use as neo-adjuvant and adjuvant therapy is being evaluated and should change in the short term the management of the disease.
