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1.
Z Rheumatol ; 75(9): 943-944, 2016 Nov.
Article in German | MEDLINE | ID: mdl-27590605

ABSTRACT

Intra-articular radiation synovectomy is an established and well documented therapy in rheumatology. A rare side effect is necrosis of surrounding tissue caused by leakage of the radionuclide.We describe the case of a 34-year old patient with rheumatoid arthritis who developed skin necrosis 4 weeks after an intra-articular radiation synovectomy of the left wrist. When these lesions are recognized early surgical therapy or hyperbaric oxygen therapy can be initiated.


Subject(s)
Arthritis, Rheumatoid/radiotherapy , Radiation Injuries/diagnosis , Radiation Injuries/etiology , Radiodermatitis/diagnosis , Radiodermatitis/etiology , Radiosurgery/adverse effects , Adult , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/diagnosis , Female , Humans , Necrosis , Skin/pathology , Skin/radiation effects , Synovial Membrane/radiation effects , Treatment Outcome
2.
Z Rheumatol ; 74(8): 728-30, 2015 Oct.
Article in German | MEDLINE | ID: mdl-26450436

ABSTRACT

Secondary hypertrophic osteoarthropathy, also known as Marie-Bamberger disease, occurs in up to 5 % of patients with non-small cell lung cancer (NSCLC). If the syndrome constellation of finger clubbing and bone pain on palpation is recognized early, lung cancer can be diagnosed at an early stage. This article reports the case of a 52-year-old male patient with knee pain, distal edema, watchglass nails and finger clubbing which first appeared in August 2013. Following angiologic, cardiologic and orthopedic consultations radiographs of the hands, feet and lungs were taken. Following the presumptive diagnosis of hypertrophic osteoarthropathy, the patient was referred to a specialist pulmonary clinic where an adenocarcinoma of the lungs was diagnosed.


Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnosis , Early Detection of Cancer/methods , Fingers/diagnostic imaging , Lung Neoplasms/diagnosis , Osteoarthropathy, Secondary Hypertrophic/diagnosis , Diagnosis, Differential , Humans , Male , Middle Aged , Radiography , Syndrome
3.
Z Rheumatol ; 73(3): 281-4, 2014 Apr.
Article in German | MEDLINE | ID: mdl-24599357

ABSTRACT

Atrial myxomas are detectable in 0.3 % of all autopsies and women are affected three times more often than men. The overall incidence of myxoma is relatively rare with 0.5 per one million inhabitants per year. Clinical signs, such as palpitations, dyspnea, dizziness and syncope or thromboembolic events may be found. Microembolic infarction or a higher expression of interleukin 6 may lead to misdiagnosis, such as vasculitis. This article presents the case of a 25-year-old woman with arthralgia, dysesthesia, staggering vertigo, cutaneous nodules and disturbed vision. Diagnostic procedures did not reveal a reason for these complaints. A therapeutic test with prednisolone did not improve the symptoms. Finally echocardiography showed a large space-occupying lesion in the left atrium which oscillated into the left ventricle during diastole. The patient was transferred to the department of cardiac surgery where the atrial myxoma could be removed without any complications and the patient ultimately made a complete recovery.


Subject(s)
Diagnostic Errors/prevention & control , Heart Neoplasms/diagnosis , Heart Neoplasms/surgery , Myxoma/diagnosis , Myxoma/surgery , Systemic Inflammatory Response Syndrome/diagnosis , Adult , Diagnosis, Differential , Female , Heart Atria/surgery , Humans , Systemic Inflammatory Response Syndrome/surgery , Treatment Outcome
4.
Bone Marrow Transplant ; 47(10): 1321-5, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22327130

ABSTRACT

Germ cell cancer (GCC) is curable in metastatic stages. The International Germ Cell Cancer Collaborative Group (IGCCCG) reports a poor prognosis subgroup with a 5-year survival of 48%. High-dose chemotherapy with PBSC transplantation (HD-PBSCT) in these patients showed promising results in phase II, but failed to show significant advantage in randomized trials. We report our monocenter series of all poor and selected intermediate prognosis germ cell tumor patients treated with multiple-course HD-PBSCT and secondary surgery of remaining tissue. We performed a retrospective analysis of our complete series of 44 patients (40 poor prognosis and 4 intermediate prognosis) treated by HD-PBSCT as part of first-line therapy from 1999 to 2010. The CR rate after up to four cycles of HD-PBSCT and radical resection of residual manifestations was 73%. The 3-year survival rate was 79.5% (median follow-up of 51.5 months; range: 7-143 months). Disease-related death rate was 16%. HD-PBSCT-related death did not occur. One patient died postsurgery. Multiple courses of HD-PBSCT with radical secondary surgery is safe and effective in poor prognosis metastatic GCC. Despite disappointing phase III studies it is of high interest to further study this field.


Subject(s)
Neoplasms, Germ Cell and Embryonal/mortality , Neoplasms, Germ Cell and Embryonal/therapy , Peripheral Blood Stem Cell Transplantation , Adolescent , Adult , Disease-Free Survival , Female , Humans , Male , Middle Aged , Neoplasm Metastasis , Neoplasms, Germ Cell and Embryonal/pathology , Retrospective Studies , Survival Rate , Transplantation, Autologous
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