ABSTRACT
This paper presents an atypical case of a patient with brain tumor of the glioblastoma multiforme (GBM) type who achieved a 5-year survival. Some general information is provided including epidemiology, diagnostic and treatment procedures (surgery and radio-chemo-therapy), and prognosis of survival related to GBM. The course of the disease, including its main symptoms, individual reasons for the delay of adjuvant treatment, after the primary surgical treatment, 37-month period of the decease free survival, as well as comprehensive management after the tumor recurrence are also presented. Histopathology confirming the clinical diagnosis is discussed in a separate chapter.
ABSTRACT
PURPOSE: To estimate bladder movements and changes in dose distribution in the bladder and surrounding tissues associated with changes in bladder filling and to estimate the internal treatment margins. METHODS AND MATERIALS: A total of 16 patients with bladder cancer underwent planning computed tomography scans with 80- and 150-mL bladder volumes. The bladder displacements associated with the change in volume were measured. Each patient had treatment plans constructed for a "partially empty" (80 mL) and a "partially full" (150 mL) bladder. An additional plan was constructed for tumor irradiation alone. A subsequent 9 patients underwent sequential weekly computed tomography scanning during radiotherapy to verify the bladder movements and estimate the internal margins. RESULTS: Bladder movements were mainly observed cranially, and the estimated internal margins were nonuniform and largest (>2 cm) anteriorly and cranially. The dose distribution in the bladder worsened if the bladder increased in volume: 70% of patients (11 of 16) would have had bladder underdosed to <95% of the prescribed dose. The dose distribution in the rectum and intestines was better with a "partially empty" bladder (volume that received >70%, 80%, and 90% of the prescribed dose was 23%, 20%, and 15% for the rectum and 162, 144, 123 cm(3) for the intestines, respectively) than with a "partially full" bladder (volume that received >70%, 80%, and 90% of the prescribed dose was 28%, 24%, and 18% for the rectum and 180, 158, 136 cm(3) for the intestines, respectively). The change in bladder filling during RT was significant for the dose distribution in the intestines. Tumor irradiation alone was significantly better than whole bladder irradiation in terms of organ sparing. CONCLUSION: The displacements of the bladder due to volume changes were mainly related to the upper wall. The internal margins should be nonuniform, with the largest margins cranially and anteriorly. The changes in bladder filling during RT could influence the dose distribution in the bladder and intestines. The dose distribution in the rectum and bowel was slightly better with a "partially empty" than with a "full" bladder.
Subject(s)
Movement , Radiotherapy Planning, Computer-Assisted/methods , Radiotherapy, Conformal/methods , Rectum/radiation effects , Urinary Bladder Neoplasms/radiotherapy , Urinary Bladder/radiation effects , Female , Humans , Intestines/diagnostic imaging , Intestines/radiation effects , Male , Radiation Dosage , Rectum/diagnostic imaging , Tomography, X-Ray Computed , Urinary Bladder/anatomy & histology , Urinary Bladder/diagnostic imaging , Urinary Bladder Neoplasms/diagnostic imaging , Urinary Bladder Neoplasms/pathologyABSTRACT
INTRODUCTION: The cases of simultaneous carcinomas of tonsilla palatina are not often described in the literature and they form a complex diagnostic and therapeutic problem. MATERIAL AND METHODS: The rare case of simultaneous bilateral cancer of tonsilla palatina with large metastases to lymphoid glands of the neck was described in this paper. Clinical disorders of only one tonsilla were visible. Epidemiology and general ways of treatment were presented. CONCLUSIONS: The precautions should be taken in the presence of bilateral metastases to the lymph nodes of the neck. The risk of bilateral simultaneous carcinoma of the tonsilla palatina is probable. Bilateral tonsillectomy should be a routine step in search on for the primary.
Subject(s)
Carcinoma, Squamous Cell , Neoplasms, Multiple Primary , Tonsillar Neoplasms , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/therapy , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/therapy , Tonsillar Neoplasms/pathology , Tonsillar Neoplasms/therapy , Treatment OutcomeABSTRACT
Osteoblastoma agressiva is not often bone tumor, only locally malignant. There are not articles, describing extra skeleton localization. Authors presented case of 45 year old patient, who was treated because of Aggressive Osteoblastoma localized in larynx. Patient has received operation and irradiation treatment. The tumor localization and patients age--more than 35 year are unusual.
