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1.
Int J Gynecol Cancer ; 16(5): 1933-5, 2006.
Article in English | MEDLINE | ID: mdl-17009994

ABSTRACT

Metastatic carcinoma of the spleen occurs in a setting of widespread malignant disease. Solitary parenchymal splenic metastasis of ovarian carcinoma is rare. We report a case of a 59-year-old woman who presented with an elevated serum CA125 level due to a solitary splenic metastasis after a long disease-free period. She was treated with laparoscopic splenectomy followed by chemotherapy. The literature contains 16 cases of solitary parenchymal splenic metastasis of ovarian carcinoma. Our case is the third case that was treated with laparoscopic splenectomy. We review the literature, and we focus on the laparoscopic approach in managing these cases.


Subject(s)
Cystadenocarcinoma, Serous/secondary , Ovarian Neoplasms/pathology , Splenic Neoplasms/secondary , CA-125 Antigen/blood , Cystadenocarcinoma, Serous/surgery , Female , Humans , Laparoscopy/methods , Middle Aged , Ovarian Neoplasms/therapy , Spleen/pathology , Spleen/surgery , Splenic Neoplasms/surgery
4.
Eur J Gynaecol Oncol ; 26(4): 443-5, 2005.
Article in English | MEDLINE | ID: mdl-16122199

ABSTRACT

Pure primary squamous cell carcinoma (SCC) of the breast is a rare condition. The exact histogenesis of this malignancy is unclear. The rarity of the condition makes it difficult to draw firm conclusions on the course of the disease and the overall prognosis. We report a case of pure primary SCC of the breast occurring in a 62-year-old woman and presenting as an enlarged breast lesion with bleeding. We also review the literature for all cases of pure primary SCC.


Subject(s)
Breast Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Female , Humans , Mastectomy , Middle Aged , Neoplasm Invasiveness , Radiotherapy, Adjuvant
8.
Am J Clin Oncol ; 22(3): 298-302, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10362341

ABSTRACT

The purpose of this study was to evaluate the combination of cisplatin and vinorelbine (PVn) for relapsed and chemotherapy-pretreated metastatic breast cancer. Twenty-three patients with metastatic breast cancer and prior chemotherapy were entered in a phase II study between June 1993 and December 1994. Eleven patients were premenopausal and 12 were postmenopausal. Follow-up data up to June 1997 are presented. All patients received cisplatin at a dose of 90 mg/m2 divided over 3 days as 30 mg/m2 infused over 4 hours. Intravenous vinorelbine 25 mg/m2 was given on days 1 and 8 or 15 according to patients' blood counts. Cycles were given every 3 to 4 weeks. An overall response rate of 61% (16/23 patients) was observed. Complete remission was obtained in six patients (26%) and partial remission was obtained in nine patients (35%). The duration of response ranged from 3 to 9 months, with an average of 4 months. Stable disease was noted in 29.1% and progressive disease in 8.3%. Overall survival at 12 months was 50%, and at 36 months it was 8%. Five of 12 patients (42%) who had prior doxorubicin therapy responded well to cisplatin-vinorelbine. Of those 12, seven were refractory and progressive on a doxorubicin-containing regimen, one had complete remission, and four had partial remission. Hematologic toxicity was acceptable. Treatment was delayed because of neutropenia in nine cycles (9.2%) and grade 2 leukopenia occurred in 54% of cycles. Febrile neutropenia occurred in seven cycles (7.1%), and five cycles were complicated by documented sepsis (5.1%). No treatment-related mortality occurred. Thrombocytopenia (grade 3) was seen in 27% of cycles, with no patient having a platelet count below 50,000 or bleeding episodes. Other toxicities were not major or dose-limiting. In conclusion, the combination of cisplatin and vinorelbine produced good responses: 61% response rate (16 of 23 patients) in relapsed, refractory, and heavily pretreated metastatic breast cancer, with 50% survival at 1 year, 12% at 2 years, and 8% at 3 years. In addition, a response rate of 42% (5 of 12 patients) was seen in patients resistant to anthracyclines.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Neoplasm Recurrence, Local/drug therapy , Adult , Aged , Cisplatin/administration & dosage , Drug Administration Schedule , Female , Humans , Middle Aged , Vinblastine/administration & dosage , Vinblastine/analogs & derivatives , Vinorelbine
10.
J Med Liban ; 46(1): 4-11, 1998.
Article in English | MEDLINE | ID: mdl-9795515

ABSTRACT

Cancers seen and recorded between 1983 and 1995 in the Hospital Tumor Registry at the American University of Beirut Medical Center (AUBMC), one of the largest primary and tertiary care hospitals in Lebanon, were retrospectively reviewed and analyzed. There was a total of 10,220 cases, excluding 916 skin cancers other than skin melanoma, averaging 786 cases per year. There were 5086 cancer cases in males with the five most common cancers being: lung cancer (915 cases: 17.9%) followed by bladder cancer (503 cases: 9.8%), larynx (438 cases: 8.6%), lymphoma (393 cases: 7.7%) and leukemia (336 cases: 6.6%). As for female cancer cases, a total of 5134 cases were observed with the five most common cancers being: breast cancer (1821 cases), followed by cervical cancer (535 cases), colo-rectal cancer (256 cases: 4.9%), lymphoma (232 cases: 4.5%), and brain cancer (213 cases: 4.1%). The average age for all cancer cases was 50.5 years with a standard deviation (SD) of 18.8 years. The average age of females (48.8 yrs; SD 17.4) was relatively lower than that of males (52.2 yrs; SD 19.9) and the difference was statistically significant. 40.6% of the patients were under the age of 50 years. 49% of breast cancer patients were below 50 years of age. In children less than 15 years of age, there were 555 cases, with leukemia being the commonest (185 cases: 33.3% of childhood cases) followed by brain cancer (112 cases: 20.1%), lymphoma (63 cases: 11.3%), bone cancer (41 cases: 7.3%), soft tissue sarcoma (35 cases: 6.3%) and kidney cancer (28 cases: 5.0%). Lung cancer in males and breast cancer in females are the most common cancers in Lebanon. These cancers are amenable to prevention (cigarette cessation and anti-smoking campaigns for lung cancer) and early detection (screening, regular breast examination and mammography for breast cancer). Our paper emphasizes the importance of addressing those and other issues including bladder cancer and age at diagnosis of breast cancer. It also presents important epidemiological and historical reference data on cancer in Lebanon during the civil war and immediately after it.


Subject(s)
Neoplasms/epidemiology , Adolescent , Adult , Age Distribution , Aged , Child , Developed Countries , Developing Countries , Female , Hospitals, University , Humans , Lebanon/epidemiology , Male , Middle Aged , Neoplasms/diagnosis , Neoplasms/therapy , Population Surveillance , Registries , Sex Distribution
11.
Eur J Gynaecol Oncol ; 19(4): 408-9, 1998.
Article in English | MEDLINE | ID: mdl-9744739

ABSTRACT

A 58-year-old woman underwent abdominal hysterectomy and bilateral salpingo-oophorectomy for stage Ib, grade 2 endometrial adenocarcinoma followed by external pelvic irradiation. Five years later she presented with a 7 cm solitary infraumbilical incisional tumor recurrence that was resected. Histology of the tumor implant was similar to that of the primary cancer. The patient was then started on progestin therapy with no evidence of recurrence for four years. To our knowledge this is the fourth reported case of endometrial cancer implanting in an abdominal scar.


Subject(s)
Adenocarcinoma/diagnosis , Cicatrix/pathology , Endometrial Neoplasms/diagnosis , Neoplasm Seeding , Adenocarcinoma/surgery , Endometrial Neoplasms/surgery , Female , Humans , Laparotomy , Middle Aged , Neoplasm Recurrence, Local , Surgical Procedures, Operative/adverse effects
12.
Ann Epidemiol ; 8(1): 46-51, 1998 Jan.
Article in English | MEDLINE | ID: mdl-9465993

ABSTRACT

PURPOSE: Cancers recorded in the Tumor Registry at the American University of Beirut Medical Center (AUBMC), the largest tertiary care center, in Lebanon were reviewed. METHODS: Results were compared with those from the same center 30 years ago and current data from western Asia. RESULTS: Between 1983 and 1994, 9364 cases were recorded, averaging 780 cases per year, representing more than one-third of the national case-load. Cases were almost equally distributed between males and females. Average age of females was significantly younger (48.7 years) than that of males (52.2 years). Among males, the five most frequently reported cancers were of the lung, bladder, larynx, lymphoma, and leukemia. Among females, the four most frequently reported cancers were of the breast, cervix uteri, lymphoma, and brain, with leukemia and corpus uteri ranking equally as fifth. Over the past 30 years, the frequency of colorectal cancer decreased and that of lung cancer increased in both sexes. Oral cancer decreased dramatically among males. Digestive system cancers in this series were less frequent than in cumulative data from western Asia area. CONCLUSIONS: Cancer dynamics changed little since the 1950s, except regard to cancers related to smoking and diet. Diet differences may explain the lower frequencies of digestive cancers in Lebanon as compared with elsewhere in western Asia. The potential impact of cancer prevention and early detection on highly prevalent cancer types such as lung, larynx, breast, and cervix was highlighted.


Subject(s)
Neoplasms/epidemiology , Registries , Academic Medical Centers , Adolescent , Age Distribution , Child , Databases, Factual , Diet/adverse effects , Female , Humans , Incidence , Lebanon/epidemiology , Male , Middle Aged , Neoplasms/etiology , Population Surveillance , Sex Distribution , Smoking/adverse effects
13.
J Infect ; 35(2): 179-82, 1997 Sep.
Article in English | MEDLINE | ID: mdl-9354355

ABSTRACT

This is the first report of granulocyte macrophage-colony stimulating factor (GM-CSF) inducing accelerated healing of a sacral pressure ulcer in a bedridden patient with bilateral hemiplegia. GM-CSF was diluted and injected locally around and into the ulcer bed every 2-3 days for 2 weeks, then weekly for 4 weeks until complete healing occurred. A new firm granulation tissue was noted within a few days. The ulcer showed 85% healing within 2 weeks and 100% by 2 months. Healing started from the periphery and from within the ulcer bed at sites of GM-CSF injections. It was slower at areas where there was complete necrosis and detachment of skin from underlying tissue. The ulcer remained closed until the patient's sudden death 9 months later. A biopsy of granulation tissue showed inflammatory cells and reactive fibroblasts. The potential role of GM-CSF and growth factors in pressure ulcer therapy and wound healing are discussed.


Subject(s)
Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use , Pressure Ulcer/drug therapy , Wound Healing/drug effects , Aged , Hemiplegia/complications , Humans , Injections, Intralesional , Male , Pressure Ulcer/complications , Pressure Ulcer/pathology , Sacrococcygeal Region
14.
Am J Gastroenterol ; 92(2): 329-31, 1997 Feb.
Article in English | MEDLINE | ID: mdl-9040217

ABSTRACT

Leptomeningeal involvement is usually reported as a secondary event in advanced, already diagnosed, gastric adenocarcinoma. We report a case of leptomeningeal carcinomatosis in which identification of mucus-secreting "signet-ring" carcinoma cells in the cerebrospinal fluid allowed the diagnosis of an otherwise asymptomatic gastric cancer. This is one of the very few reported cases manifesting as such in the medical literature.


Subject(s)
Adenocarcinoma/diagnosis , Carcinoma, Signet Ring Cell/diagnosis , Meningeal Neoplasms/diagnosis , Stomach Neoplasms/diagnosis , Adenocarcinoma/drug therapy , Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Signet Ring Cell/drug therapy , Carcinoma, Signet Ring Cell/secondary , Doxorubicin/administration & dosage , Fluorouracil/administration & dosage , Humans , Male , Meningeal Neoplasms/drug therapy , Meningeal Neoplasms/secondary , Methotrexate/administration & dosage , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Stomach Neoplasms/drug therapy
15.
Eur J Obstet Gynecol Reprod Biol ; 60(1): 85-6, 1995 May.
Article in English | MEDLINE | ID: mdl-7635238

ABSTRACT

The use of alkylating agents has been reported to be a cause of secondary leukemia particularly in patients surviving for 2 years or more after treatment of ovarian carcinoma. The risk of developing leukemia is possibly related to the duration of treatment and the total dose of alkylating agents administered. We report a patient with epithelial ovarian carcinoma who received chlorambucil for 130 consecutive months with no clinical or laboratory evidence of leukemia.


Subject(s)
Chlorambucil/therapeutic use , Cystadenocarcinoma/drug therapy , Ovarian Neoplasms/drug therapy , Chlorambucil/administration & dosage , Chlorambucil/adverse effects , Cystadenocarcinoma/pathology , Cystadenocarcinoma/surgery , Female , Humans , Leukemia/chemically induced , Middle Aged , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery
16.
Gynecol Oncol ; 52(1): 91-3, 1994 Jan.
Article in English | MEDLINE | ID: mdl-8307508

ABSTRACT

The present report describes a 27-year-old woman diagnosed with Ann Arbor stage IE primary malignant lymphoma of the cervix. Radiation therapy was instituted as conventionally advocated at this early stage of the disease. Despite adequate local tumor response, central nervous system metastasis occurred a few months later. She succumbed to her condition 7 months after initial diagnosis. As occult distant foci may not be amenable to detection by available imaging techniques at the time of initial work-up, combination chemotherapy alone or in conjunction with radiation therapy may be the most appropriate first line of therapy in patients with stage IE primary malignant lymphoma of the cervix.


Subject(s)
Brain Neoplasms/secondary , Lymphoma/radiotherapy , Uterine Cervical Neoplasms/radiotherapy , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Female , Humans , Lymphoma/pathology , Neoplasm Staging , Prednisolone/administration & dosage , Prednisolone/adverse effects , Scalp , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/secondary , Uterine Cervical Neoplasms/pathology , Vincristine/administration & dosage , Vincristine/adverse effects
17.
Gynecol Oncol ; 51(2): 258-60, 1993 Nov.
Article in English | MEDLINE | ID: mdl-8276304

ABSTRACT

Acute tumor lysis syndrome (ATLS) is a rare metabolic complication in nonhematologic malignancies. We report a unique case of extensive regionally recurrent squamous cell carcinoma of the vulva who developed a picture compatible with ATLS 36 hr after the initiation of palliative chemotherapy. The patient suffered acute renal failure with hyperuricemia, hyperphosphatemia, and hypocalcemia as well as a picture suggestive of congestive heart failure. The patient responded well to adequate hydration, alkaline diuresis, and allopurinol. The potential for ATLS should be anticipated when treating metastatic or locally advanced squamous cell carcinoma of the vulva with chemotherapy.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma, Squamous Cell/complications , Tumor Lysis Syndrome/etiology , Vulvar Neoplasms/complications , Aged , Carcinoma, Squamous Cell/drug therapy , Cisplatin/administration & dosage , Cisplatin/adverse effects , Female , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Humans , Lymphatic Metastasis , Vulvar Neoplasms/drug therapy
18.
Gynecol Oncol ; 50(3): 389-93, 1993 Sep.
Article in English | MEDLINE | ID: mdl-8406208

ABSTRACT

Primary malignant lymphoma of the female urethra is a rare entity. Five cases of non-Hodgkin's lymphoma of the female urethra have been previously reported. We report another case presenting with a urethral caruncle. A review of the literature is included.


Subject(s)
Lymphoma, Non-Hodgkin/pathology , Urethral Diseases/pathology , Urethral Neoplasms/pathology , Aged , Diagnosis, Differential , Female , Humans
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