ABSTRACT
Severe (stage IV) duodenal polyposis is difficult to manage in patients with familial adenomatous polyposis (FAP), with no effective medical treatment, complex endoscopic treatment modalities, and a high morbidity and mortality from pancreaticoduodenectomy. We present the case of a 44-year-old woman with FAP, stage IV duodenal polyposis, and with an ileal pouch adenocarcinoma that required surgery and adjuvant chemotherapy. Her duodenal polyposis regressed to stage II after four sessions of FOLFOX4 adjuvant chemotherapy, which avoided the need for aggressive endoscopic therapy or pancreatoduodenectomy in this patient.
Subject(s)
Adenocarcinoma/drug therapy , Adenomatous Polyposis Coli/surgery , Antineoplastic Combined Chemotherapy Protocols , Colonic Pouches/pathology , Duodenal Neoplasms/drug therapy , Adenocarcinoma/complications , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adenomatous Polyposis Coli/complications , Adenomatous Polyposis Coli/pathology , Adult , Biopsy, Needle , Chemotherapy, Adjuvant , Duodenal Neoplasms/complications , Duodenal Neoplasms/pathology , Duodenal Neoplasms/surgery , Duodenoscopy/methods , Female , Fluorouracil , Follow-Up Studies , Humans , Immunohistochemistry , Leucovorin , Organoplatinum Compounds , Proctocolectomy, Restorative/adverse effects , Proctocolectomy, Restorative/methods , Risk Assessment , Treatment OutcomeABSTRACT
Thyroid consequences of cancer therapy are multiple, better known after radiotherapy than after chemotherapy and recently described with targeted therapies. Cervical or total body irradiation may result in thyroid insufficiency or cancer. The consequences of treatment with new antiangiogenic drugs are under evaluation; however their effect on thyroid function is already well established. Thyroid dysfunction usually occurs late, several months or years after treatment and have to be depicted. There is an improvement in the overall survival of patients suffering from cancer and endocrinologists must be aware of the endocrine effects of treatments to propose an adequate survey and an appropriate treatment to improve well-being of patients.
Subject(s)
Antineoplastic Agents/adverse effects , Neoplasms/therapy , Thyroid Diseases/etiology , Angiogenesis Inhibitors/adverse effects , Angiogenesis Inhibitors/therapeutic use , Antineoplastic Agents/therapeutic use , Humans , Mitotane/adverse effects , Mitotane/therapeutic use , Neoplasms/drug therapy , Neoplasms/radiotherapy , Protein-Tyrosine Kinases/antagonists & inhibitors , TOR Serine-Threonine Kinases/antagonists & inhibitors , Thyroid Function TestsABSTRACT
The association between diabetes mellitus and hypokinetic cardiomyopathy is frequent. We report a case of diabetes and hypokinetic cardiopathy in a 40-year-old man which led to the hypothesis of maternally inherited diabetes and deafness (MIDD) due to a mitochondrial disease. This diagnosis was confirmed by genetic testing which showed a DNA A3243G mutation in the mitochondria, the prevalence of which is 1-2% in diabetes mellitus. Cardiac abnormalities are frequent (18-34% of patients depending on the series) and the co-existence of left ventricular hypertrophy and systolic dysfunction is suggestive of this disease. Some authors have proposed co-enzyme Q as a treatment to improve the left ventricular ejection fraction and insulin secretion.
Subject(s)
Cardiomyopathy, Dilated/diagnosis , Diabetes Mellitus/diagnosis , Diabetes Mellitus/genetics , Mitochondrial Diseases/diagnosis , Adult , Cardiomyopathy, Dilated/genetics , DNA Mutational Analysis , DNA, Mitochondrial/genetics , Deafness/diagnosis , Deafness/genetics , Diagnosis, Differential , Echocardiography , Genes, Mitochondrial/genetics , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Mitochondrial Diseases/genetics , SyndromeABSTRACT
In France, tuberculosis (TB) is still a health issue among underprivileged people and immigrants. We report a case of disseminated tuberculosis with intestinal involvement causing ill absorption and thus, making oral treatment impossible. Intestinal TB is often underrated and yet, malabsorption may lead to treatment failure or to developing antibiotic resistance. This type of tuberculosis must be systematically investigated when assessing the damage caused by tuberculosis and, more particularly, if there is any abdominal pain as well as clinical and biological signs of malabsorption. Parenteral antibiotherapy and nutrition must be systematically discussed.
