ABSTRACT
AIMS: To determine the distribution of inguinal nodes around the vessels, margins needed around the vessels and inferior extent of contouring in the inguinal region. SUBJECTS AND METHODS: Fifty patients having pelvic malignancies with one or more malignant nodes in the inguinal region were retrospectively included in this study. The position of the nodes in relation to the vessels, size of the nodes, the distance from the center of the node to the edge of the nearest vessel was measured. Margins required to cover the nodes from the vessels and position of the nodes in relation to the lesser trochanter was noted. RESULTS: Most of the nodes were placed either anteromedial (46%) or anterior (46.6%) to the vessels (92.6%). The range of margin required to cover all nodes in the anteromedial, anterior and anteriolateral direction varied from 0.8 to 2.7 cm. Only one node was more than 2 cm below the lower edge of lesser trochanter. CONCLUSION: Elective clinical target volume for inguinal lymph nodes requires a minimum margin of 2.5 cm from the femoral vessels in the anterior, anterolateral and anteromedial direction 1.5 cm margin is required medially. Inferior extent of the contour should be 2 cm below the lower edge of lesser trochanter.
Subject(s)
Femoral Vein/pathology , Lymph Nodes/pathology , Pelvic Neoplasms/pathology , Uterine Cervical Neoplasms/pathology , Blood Vessels/pathology , Female , Femoral Vein/diagnostic imaging , Femoral Vein/surgery , Femur/blood supply , Femur/diagnostic imaging , Femur/pathology , Humans , Lymph Node Excision , Lymph Nodes/diagnostic imaging , Lymph Nodes/surgery , Lymphatic Metastasis , Pelvic Neoplasms/diagnostic imaging , Pelvic Neoplasms/surgery , Radiography , Retrospective Studies , Uterine Cervical Neoplasms/diagnostic imaging , Uterine Cervical Neoplasms/surgeryABSTRACT
We present an unusual case of a large metastatic lesion from carcinoma cervix located in the clivus. Patient presented with severe headache and vomiting, mimicking an intracranial pathology. Radiological imaging suggested metastatic origin of the lesion and later on investigations revealed primary in the uterine cervix. The anatomic importance of extradural neural axis component in the process of metastasis of carcinoma cervix to the clivus is highlighted in this case report.
Subject(s)
Carcinoma/diagnostic imaging , Skull Base Neoplasms/diagnostic imaging , Uterine Cervical Neoplasms/diagnostic imaging , Carcinoma/secondary , Fatal Outcome , Female , Humans , Middle Aged , Radiography , Skull Base Neoplasms/secondary , Uterine Cervical Neoplasms/pathologyABSTRACT
We present this unusual case of cisplatin-induced acute myocardial infarction in a patient with no organic coronary artery disease (CAD), receiving chemoradiation for small cell lung cancer. Patient developed symptoms of acute coronary syndrome after receiving two cycles of cisplatin and etoposide. The possible mechanism of vasospasm induced by cisplatin, in the background of thoracic radiation and hypomagnesemia, is discussed in this case report.
