ABSTRACT
Neoplastic recurrence is the most common cause of death after surgery for esophageal cancer. The Authors review the therapeutic options evaluating in terms of palliation of dysphagia and complication and mortality rates. Prognostic factors and mechanisms determining the recurrence are also reviewed. A strategy for a rational approach in the management of recurrent esophageal cancer emerges from both the literature and their own experience. Notwithstanding the small life span of these patients, the treatment of esophageal obstruction is mandatory. The therapeutic options that be considered are: palliative resection, surgical bypass, laser therapy, intubation, radiotherapy. The site of obstruction, the presence of metastasis, the general status can lead to the optimal choice. In terms of palliation of dysphagia the surgical approach seems to obtain the best results, even if high complication and mortality rates have been reported. Bypass is the second surgical choice when applicable. The other non-surgical modalities have been administered in large series of patients with good results. Combination therapies can obtain better results.
Subject(s)
Esophageal Neoplasms/surgery , Neoplasm Recurrence, Local/surgery , Deglutition Disorders/etiology , Deglutition Disorders/surgery , Esophageal Neoplasms/complications , Esophageal Neoplasms/pathology , Humans , Intubation, Intratracheal , Palliative CareABSTRACT
A case of supraclavicular metastatic follicular carcinoma which occurred 7 years after the patient had undergone total thyroidectomy is presented. By means of whole body 210-thallium scan, a precise diagnosis was made, while the whole body 131-I scan was negative. The thyroglobulin serum levels were high before surgery but significantly decreased after lymphadenectomy. The clinical use of this tracer to detect functioning and non-functioning metastases of thyroid carcinomas is discussed.
Subject(s)
Radioisotopes , Thallium , Thyroid Neoplasms/diagnostic imaging , Adenocarcinoma/secondary , Adenocarcinoma/surgery , Adenoma/surgery , Female , Humans , Iodine Radioisotopes , Lymph Node Excision , Lymphatic Metastasis/diagnostic imaging , Lymphatic Metastasis/surgery , Middle Aged , Radionuclide Imaging , Thyroid Neoplasms/surgery , Thyroidectomy , Whole-Body CountingABSTRACT
Incubation of human erythrocytes with inosine, pyruvate and phosphate increases several fold the ferrihemoglobin reductase activity, the values of which, however, depend on the age of blood (by 6 to 2 times with respect to the normal value of fresh blood).
