ABSTRACT
The majority of pediatric patients are cured of their primary cancer with current advanced developments in pediatric cancer therapy. However, survivors often experience long-term complications from therapies for primary cancer. The delayed mortality rate has been decreasing with the effort to reduce the therapeutic exposure of patients with pediatric cancers. Our study investigates the incidence of sarcoma as second cancer in pediatric cancer survivors. We present a 9-year-old male who survived embryonal hepatoblastoma diagnosed at 22 months of age. At 4.5 years of age, he presented with a non-metastatic primitive neuroectodermal tumor (PNET) of the left submandibular area. He has no evidence of recurrence of either cancer for 51 months after finishing all chemotherapy and radiotherapy. We used the Surveillance, Epidemiology, and End Results (SEER) database to identify the current rate of second sarcomas in pediatric cancer survivors. Our literature review and large population analysis emphasize the impact of sarcoma as a second malignancy and provide help to physicians caring for pediatric cancer survivors.
Subject(s)
Cancer Survivors/psychology , Neoplasms, Second Primary/etiology , Sarcoma/complications , Child , Hepatoblastoma , Humans , Incidence , Male , Neoplasms, Second Primary/epidemiology , Neoplasms, Second Primary/psychology , Population Surveillance/methods , Risk Factors , Sarcoma/epidemiologyABSTRACT
BACKGROUND: we report our technical success and complication rates in treating posterior circulation aneurysms at sites other than the basilar apex, superior cerebellar artery origin, or the posterior inferior cerebellar artery origin via endovascular embolization or sacrifice. MATERIALS AND METHODS: we retrospectively reviewed case records for patients undergoing coil embolization of atypical posterior circulation aneurysms from January 2003 to December 2007. RESULTS: thirty-two aneurysms in 32 patients were treated. Twenty-one patients (65%) presented with a subarachnoid hemorrhage. Twenty-two aneurysms were treated with coiling alone, 9 with stent-assisted coiling, and 1 with a combination of Onyx plus stent-assisted coiling. Twelve aneurysms were treated with vessel sacrifice. Immediately post procedure, 27/32 aneurysms (84%) were considered successfully treated, resulting in either vessel sacrifice, complete obliteration, or minimal neck remnant. Sixteen of 19 patients (84%) were considered successfully treated at a mean angiographic follow up of 8 months. The procedural morbidity and mortality was 15% and 6% respectively. CONCLUSION: endovascular embolization remains a viable and durable method of treatment for atypical posterior circulation aneurysms.
Subject(s)
Aneurysm, Ruptured/therapy , Embolization, Therapeutic/methods , Intracranial Aneurysm/therapy , Subarachnoid Hemorrhage/therapy , Adult , Aged , Aneurysm, Ruptured/complications , Aneurysm, Ruptured/diagnostic imaging , Basilar Artery/diagnostic imaging , Cerebral Angiography , Female , Humans , Intracranial Aneurysm/complications , Intracranial Aneurysm/diagnostic imaging , Male , Middle Aged , Retrospective Studies , Stents , Subarachnoid Hemorrhage/diagnostic imaging , Subarachnoid Hemorrhage/etiology , Treatment Outcome , Vertebral Artery/diagnostic imagingABSTRACT
BACKGROUND: We sought to report our technical success and complications in treating distal anterior cerebral artery (ACA) aneurysms with coil embolization. METHODS: We retrospectively reviewed all patients undergoing coil embolization of distal ACA aneurysms from September 1999 to March 2008. Patients were assessed for subarachnoid hemorrhage, fundus size, and fundus-to-neck ratio (F/N) < 2 or >or= 2. Technical success for aneurysms was assessed according to established criteria immediately post-procedure and at 6-month angiographic follow-up. Post-procedural outcomes were measured using the modified Rankin Scale (mRS) at discharge. A mRS