ABSTRACT
Three women presented with malignant thyroid lymphoma (stage IE and IIE) that was associated with Hashimoto's thyroiditis. Each patient was treated with combination chemotherapy (two patients received cyclophosphamide/adriamycin/vincristine/prednisolone, one patient received methotrexate/adriamycin/cyclophosphamide/vincristine/prednisolone/ble omy cin) as the primary mode of therapy. One patient underwent incomplete excisional surgery and received chemotherapy. A complete clinical and radiological remission was achieved in all patients, in spite of evidence of extensive extrathyroidal invasion in two patients. The chemotherapy was well-tolerated, producing minimal toxicity. All the patients are alive and remain free of tumour recurrence 26 to more than 38 months after diagnosis. These results suggest that combination chemotherapy can be employed successfully as a single modality treatment for stage IE and IIE thyroid lymphomas, even when significant extrathyroidal invasion is present. The treatment of thyroid lymphoma is reviewed with emphasis on the potential role for chemotherapy as the primary modality.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lymphoma, Non-Hodgkin/drug therapy , Thyroid Neoplasms/drug therapy , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Drug Administration Schedule , Drug Evaluation , Female , Humans , Lymphoma, Non-Hodgkin/diagnostic imaging , Lymphoma, Non-Hodgkin/pathology , Middle Aged , Neoplasm Staging , Prognosis , Remission Induction , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/pathology , Thyroiditis/complications , Tomography, X-Ray ComputedSubject(s)
Adenocarcinoma/pathology , Blood Coagulation Tests , Gallbladder Neoplasms/pathology , Heparin/adverse effects , Pulmonary Embolism/chemically induced , Thrombocytopenia/chemically induced , Thrombophlebitis/chemically induced , Gallbladder/pathology , Humans , Male , Middle Aged , Pulmonary Embolism/pathology , Thrombocytopenia/pathology , Thrombophlebitis/pathology , Veins/pathologyABSTRACT
A 37 year old man who presented with a cardiomyopathy, conduction defects and atrial and ventricular arrhythmias was found to have the neuromuscular manifestations of myotonic dystrophy. Despite implantation of a permanent cardiac pacemaker, antiarrhythmic drug therapy and antiarrhythmic surgery, sudden death occurred. The results of electrophysiologic studies, coronary arteriography and pathologic findings are described. This case confirms previous observations that ventricular arrhythmias, in addition to atrial arrhythmias and conduction disturbances, are cardiac manifestations of myotonic dystrophy and can lead to sudden death.
