Meningoteliomatosis pulmonar difusa: causa infrecuente de patrón micronodular / Diffuse pulmonary meningotheliomatosis: an uncommon cause of the micronodular pattern

Los meningoteliomas pulmonares son tumores raros que se manifiestan morfológicamente como nódulos de pequeño tamaño. Aparecen con mayor frecuencia en la sexta y en la séptima década de la vida, con predilección por el sexo femenino. Su etiología es desconocida y en el diagnóstico radiológico diferencial deben incluirse las enfermedades que cursan con un patrón nodular. Diversos autores han documentado una clara asociación, estadísticamente significativa, entre esta entidad y diversas enfermedades pulmonares, y la más frecuente es el adenocarcinoma de pulmón. Existen actualmente muy pocos casos radiológicos documentados en la literatura médica. Presentamos el caso de una paciente con antecedentes de carcinoma de mama y de recto metacrónicos. En el estudio de extensión de este último se evidenció un patrón micronodular pulmonar bilateral. Los hallazgos radiológicos se interpretaron inicialmente como metástasis y se alcanzó el diagnóstico definitivo de meningoteliomatosis mediante biopsia pulmonar (AU)

Pulmonary meningotheliomas are rare tumors that manifest as small nodules. They are most common in the sixth and seventh decades of life and are more common in women. Their cause is unknown and the imaging differential diagnosis should include other diseases that course with nodular patterns. Several authors have documented a statistically significant association between pulmonary meningotheliomatosis and diverse lung diseases, with adenocarcinoma of the lung being the most frequently associated disease. Very few cases of radiologically documented meningotheliomatosis have been reported. We present a case of a patient with a history of metachronous breast and rectal cancer. A micronodular pattern was observed in both lungs during CT examination to determine the extent of rectal cancer. The radiologic findings were initially interpreted as metastases and the definitive diagnosis of meningotheliomatosis was reached after lung biopsy (AU)

[Diffuse pulmonary meningotheliomatosis: an uncommon cause of the micronodular pattern]. / Meningoteliomatosis pulmonar difusa: causa infrecuente de patrón micronodular.

Pulmonary meningotheliomas are rare tumors that manifest as small nodules. They are most common in the sixth and seventh decades of life and are more common in women. Their cause is unknown and the imaging differential diagnosis should include other diseases that course with nodular patterns. Several authors have documented a statistically significant association between pulmonary meningotheliomatosis and diverse lung diseases, with adenocarcinoma of the lung being the most frequently associated disease. Very few cases of radiologically documented meningotheliomatosis have been reported. We present a case of a patient with a history of metachronous breast and rectal cancer. A micronodular pattern was observed in both lungs during CT examination to determine the extent of rectal cancer. The radiologic findings were initially interpreted as metastases and the definitive diagnosis of meningotheliomatosis was reached after lung biopsy.

Adrenal metastasis of breast cancer with involvement of the inferior vena cava

Tumour thrombosis of the inferior cava vein is usually associated with primary renal cell cancer. To our knowledge, this is the first case reported of adrenal metastasis of breast cancer extending into the inferior vena cava. There are few references in the literature documenting this extension with positron emission tomography (PET) and enhanced computed tomography (CT). The authors focus on the role of combined PET-CT imaging in the accurate detection of malignant thrombus (AU)

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Irinotecan plus raltitrexed as first-line treatment in advanced colorectal cancer: a phase II study.

To evaluate the efficacy and toxicity of irinotecan (CPT-11) in combination with raltitrexed as first-line treatment of advanced colorectal cancer (CRC). A total of 91 previously untreated patients with advanced CRC and measurable disease were enrolled in this phase II study. The median age was 62 years (range 31-77); male/female 54/37; ECOG performance status was 0 in 50 patients (55%), one in 39 (43%) and two in two (2%). Treatment consisted of CPT-11 350 mg x m(-2) in a 30-min intravenous infusion on day 1, followed after 30 min by a 15-min infusion of raltitrexed 3 mg x m(-2). Measurements of efficacy included the following: response rate, time to disease progression and overall survival. Of the 83 evaluable patients valuable to objective response, there were five complete responses (6%) and 23 partial responses (28%), for an overall response rate of 34% (95% CI: 25.9-46.5%). In all, 36 patients (43%) had stable disease, whereas 19 (23%) had a progression. The median time to progression was 11.1 months and the median overall survival was 15.6 months. A total of 487 cycles of chemotherapy were delivered with a median of five per patient. Grade 3-4 WHO toxicities were as follows: diarrhoea in 13 patients (15%), nausea/vomiting in four (4%), transaminase increase in six (7%), stomatitis in two (2%), febrile neutropenia in three (3%), anaemia in five (6%) and asthenia in three (3%). The combination CPT-11-raltitrexed is an effective, well-tolerated and convenient regimen as front-line treatment of advanced CRC.