Subject(s)
Abdominal Neoplasms/secondary , Melanoma/pathology , Neoplasm Metastasis/pathology , Abdomen , Aged, 80 and over , Biopsy , Diagnosis, Differential , Humans , MaleABSTRACT
INTRODUCTION: Cutaneous squamous cell carcinoma is an invasive and destructive tumor, and may cause death by local extension or because of metastasis. We report the case of a patient with a giant squamous cell carcinoma of the nose and extension to the brain and discuss the main risk factors from this extension. OBSERVATION: Resection of a giant squamous cell carcinoma was performed of the nose in a 45 year-old man after debulking radiotherapy. Histological examination disclosed a well-differentiated tumor and perineural involvement, with at least a 6 mm margin. A first relapse occurred on the orbital edge of the initial resection, the lesion was removed revealing an involvement of the infra-orbital nerve. Whilst the patient was receiving chemotherapy, a second relapse occurred responsible for ophthalmoplegia and loss of vision, with involvement of the left orbital apex, cavernous sinus and temporal lobe. The patient died from grand mal seizures. DISCUSSION: Brain extension of cutaneous squamous cell carcinoma of the head is rare. It develops along the anatomic pathways, especially perineural spread. Main risk factors for such a poor course are discussed, including the size of tumor, the anatomic site, the depth and perineural invasion.
Subject(s)
Brain Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Nose Neoplasms/pathology , Brain Neoplasms/drug therapy , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Epilepsy, Tonic-Clonic/etiology , Fatal Outcome , Humans , Male , Middle Aged , Nose Neoplasms/drug therapy , Nose Neoplasms/radiotherapy , Nose Neoplasms/surgerySubject(s)
Carcinoma, Adenoid Cystic/pathology , Scalp/pathology , Skin Neoplasms/pathology , Age of Onset , Aged , Female , HumansSubject(s)
Liver/pathology , Prostatic Neoplasms/pathology , Humans , Hyperplasia , Male , Middle Aged , Prostatic Neoplasms/complicationsSubject(s)
Carcinoma, Merkel Cell/pathology , Fingers , Skin Neoplasms/pathology , Humans , Male , Middle AgedABSTRACT
Portal hypertension is rare in the setting of non-Hodgkin's lymphoma. We report here the case of a 73-year-old man presenting with diffuse high-grade B-cell lymphoma affecting predominantly the liver with large space occupying lesions. Histological examination of liver specimens showed abnormal large lymphoid cells whereas adjacent non-tumoural liver was normal. Portal hypertension was documented by upper gastrointestinal endoscopy that showed grade II oesophageal varices and measurement of portal pressures via transjugular approach showing increased hepatic venous pressure gradient (24 mmHg). We assume that portal hypertension was mainly related to these space occupying lesions.
Subject(s)
Hypertension, Portal/diagnosis , Hypertension, Portal/etiology , Liver/pathology , Lymphoma, B-Cell/complications , Aged , Fatal Outcome , Humans , Lymphoma, Non-Hodgkin/complications , MaleABSTRACT
Seven women and 3 men infected with hepatitis C virus, all of whom had failed to respond to therapy with either IFN-alpha or IFN and ribavirin, were treated with 200 mg/day of amantadine hydrochloride for 12 months. We found a significant decrease of serum ALT activity without any decrease in virus load. These results suggest that amantadine hydrochloride should not be used as monotherapy for patients who do not respond to treatment with IFN-alpha and/or ribavirin.
Subject(s)
Amantadine/therapeutic use , Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Interferon-alpha/therapeutic use , Ribavirin/therapeutic use , Alanine Transaminase/blood , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
Patients with primary immunodeficiencies are at high risk for developing haematological malignancies and, to a lesser degree, carcinoma. We report a patient with ascertained X-linked agammaglobulinaemia who developed a gastric carcinoma involving the distal part of the stomach associated with chronic atrophic gastritis and intestinal metaplasia. These latter conditions are considered to be precursor conditions and the role of chronic infections is likely. Patients with X-linked agammaglobulinaemia, as with other primary immunodeficiencies, could benefit from regular gastrointestinal evaluation, leading to early diagnosis and treatment of carcinoma.
Subject(s)
Adenocarcinoma/etiology , Agammaglobulinemia/complications , Stomach Neoplasms/etiology , Adolescent , Agammaglobulinemia/genetics , Fatal Outcome , Genetic Linkage , Humans , Male , Peritoneal Neoplasms/secondary , Risk Factors , X ChromosomeABSTRACT
OBJECTIVES: To study the epidemiological characteristics of patients with chronic hepatitis C virus followed in a primary referral hospital and the clinical influence of "systematic screening" defined as the screening of patients without symptoms and with known risk factors of hepatitis C (past transfusion, past or present intravenous drug use, haemodialysis) on the natural history and treatment of chronic hepatitis C virus. METHODS: The files of 311 consecutive patients who screened positive for anti-hepatitis C virus and were seen at the primary referral hospital, Creil, from January 1992 to February 1996, were analyzed. RESULTS: Patients who underwent "systematic screening" were younger with a shorter duration of infection. They were more often intravenous drug addicts and had lower alanine aminotransferase activity and Knodell scores than patients who underwent screening during "a diagnostic procedure", because of symptoms and/or abnormal liver biochemistry. Increased age at contamination and alcohol consumption of more than 40 g per day was associated with an increased risk of cirrhosis while patients who underwent "systematic screening" had a lower risk of cirrhosis and higher survival rate. Interferon therapy was attempted less often in anti-hepatitis C virus positive patients from "systematic screening" programs. CONCLUSIONS: Anti-hepatitis C virus positive patients from "systematic screening" programs had a benign disease and were rarely treated with interferon compared to anti-hepatitis C virus positive patients diagnosed during a "diagnostic procedure".
Subject(s)
Hepatitis C/epidemiology , Female , France , Hepatitis C/diagnosis , Hepatitis C/therapy , Hospitals, General , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Primary non-Hodgkin's lymphoma of the pancreas is a rare disease. Its diagnosis is difficult without histological examination. In fact, clinical and imaging findings are not pathognomonic. Acute pancreatitis associated with pancreatic lymphoma is extremely rare. We have found only 7 case reports in literature. We report herein a new case of pancreatic lymphoma which was revealed by a severe pancreatitis.
Subject(s)
Lymphoma, Non-Hodgkin/diagnosis , Pancreatic Neoplasms/diagnosis , Pancreatitis/diagnosis , Acute Disease , Aged , Diagnosis, Differential , Female , Humans , Lymphoma, Non-Hodgkin/complications , Lymphoma, Non-Hodgkin/pathology , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/pathology , Pancreatitis/complications , Tomography, X-Ray ComputedABSTRACT
Hepatotoxicity of cyamamezine, a phenothiazine structurally related to chlorpromazine, has been rarely documented. We report here a case of acute symptomatic hepatitis following a unique massive intake of cyamamezine in a suicide attempt and discuss the mechanisms of such injury.
Subject(s)
Chemical and Drug Induced Liver Injury/etiology , Phenothiazines/poisoning , Acute Disease , Adult , Chemical and Drug Induced Liver Injury/pathology , Female , Humans , Liver/pathology , Suicide, AttemptedABSTRACT
Two cases of severe hepatitis in young women using Atrium and paroxetine are presented. Both patients presented jaundice, marked increase in aminotransferases activities, and pronounced prolongation in prothrombin time. In both cases, liver biopsy specimen examination revealed lesions compatible with drug-related injury. Other causes of hepatic injury were reasonably ruled out by complete careful screening. Outcome was marked by rapid complete recovery in one case and by slow recovery in the other. We suggest that simultaneous treatment with Atrium and paroxetine could increase each of these drugs' hepatotoxicity.
Subject(s)
Anti-Anxiety Agents/adverse effects , Barbiturates/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Paroxetine/adverse effects , Phenobarbital/adverse effects , Selective Serotonin Reuptake Inhibitors/adverse effects , Adult , Anti-Anxiety Agents/administration & dosage , Barbiturates/administration & dosage , Chemical and Drug Induced Liver Injury/pathology , Drug Combinations , Drug Interactions , Female , Humans , Liver/pathology , Paroxetine/administration & dosage , Phenobarbital/administration & dosage , Selective Serotonin Reuptake Inhibitors/administration & dosageABSTRACT
Paracetamol is a widely used medication as it is an effective analgesic and antipyretic. Because of the absence of gastro-intestinal side effects, it has been used as the analgesic of choice for alcoholic patients. Hepatotoxicity is dose-related and generally occurs in patients who absorb more than 125 mg/kg/j. However, cases of severe liver damage have been reported after absorption of therapeutic doses of paracetamol in alcoholics. We report 2 cases with a fatal outcome and discuss the mechanisms of toxicity, the prognostic factors and treatment of such event.