RESUMEN
The authors report on a 39-year-old woman who underwent adrenalectomy because of a carcinoma and developed an isolated metastatic recurrence in the liver 4 years later, which was detected by regular screening of the level of cortisol, testosterone and androstenedione in plasma. After hemihepatectomy, normalization of the hormone levels and complete regression of all symptoms occurred. Regular screening of hormone levels in the blood after operation is of great benefit for the detection of later recurrences in hormone-active carcinomas (over 50% of the total). The surgical approach to isolated metastatic recurrences in special cases seems promising.
Asunto(s)
Neoplasias de la Corteza Suprarrenal/cirugía , Adrenalectomía , Hepatectomía , Neoplasias Hepáticas/secundario , Neoplasias de la Corteza Suprarrenal/sangre , Neoplasias de la Corteza Suprarrenal/tratamiento farmacológico , Adulto , Androstenodiona/sangre , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Terapia Combinada , Femenino , Humanos , Hidrocortisona/sangre , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/cirugía , Mitotano/uso terapéutico , Testosterona/sangreRESUMEN
120 patients with the first occurrence of TNM stage Ta or T1 bladder carcinoma were given adjuvant intravesical treatment in 2 consecutive series. The first 60 received doxorubicin monthly for 6 months, then on the 9th and 12th month following surgery. The second series was given mitomycin weekly for 2 months, then monthly to the end of the first year. Median follow-up is 48 months in the first series and 15 in the second. In the doxorubicin group, 28 patients had recurrences. The recurrence rate is 1.86/100 patient-months. Seventeen of these first relapses occurred within the first year. In the 'intensive' mitomycin series, where 36 patients were observed for 12 months or more, 3 relapsed. The recurrence rate to date is 0.35. The relapse-free survival probability at 12 months is 75% in the first series and 93% in the second. Treatment was stopped due to toxicity in 4 patients in the doxorubicin group and in 10 of the mitomycin group.
Asunto(s)
Doxorrubicina/uso terapéutico , Mitomicinas/uso terapéutico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Administración Intravesical , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Cistitis/inducido químicamente , Doxorrubicina/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mitomicinas/efectos adversos , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Neoplasias de la Vejiga Urinaria/cirugíaRESUMEN
Ex vivo surgery with replantation of the kidney into the renal fossa was used to treat a centrally located renal hydatid cyst in a 44-year-old patient. The replanted kidney showed good urographic function 2 months postoperatively. Orthotopic replantation of the kidney into its original location is preferred to heterotopic autotransplantation into the groin.
