RESUMO
We report a case of liver metastasis of renal cell carcinoma with portal venous tumor thrombus. Abdominal computed tomographic images showed a large hepatic mass that enhanced slightly during arterial phase. Multiple hypoattenuating lesions were seen in the intrahepatic portal venous branches and were traced directly from the mass. The histologic specimen confirmed metastatic liver tumor of renal cell carcinoma with portal venous tumor thrombus.
Assuntos
Carcinoma de Células Renais/secundário , Neoplasias Renais/patologia , Neoplasias Hepáticas/secundário , Recidiva Local de Neoplasia/diagnóstico , Veia Porta/diagnóstico por imagem , Trombose/diagnóstico , Adulto , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/cirurgia , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/cirurgia , Masculino , Recidiva Local de Neoplasia/cirurgia , Veia Porta/cirurgia , Doenças Raras , Trombose/etiologia , Trombose/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Four fungal metabolites, chaetoglobosin A (CGA), crinipellin B (CPB), geodin (GE) and triticone B (TTB), were found to enhance fibrinolytic activity of bovine aortic endothelial cells. Plasmin generation on the cells was elevated 2- to 4-fold when treated with these agents at a concentration of 3 approximately 100 microM. These effects were dependent on plasminogen and inhibited by anti-urokinase antibody. The effect of CGA, but not of CPB, GE and TTB, was abolished by cycloheximide. In a cell-free system, plasmin and urokinase activities as well as urokinase-catalyzed plasminogen activation were not enhanced by these agents. CGA, but not others, induced the production of urokinase in endothelial cells. CPB and GE accelerated plasminogen activator inhibitor- 1 (PAI-1) inactivation, and TTB caused direct, reversible inhibition of PAI-1. Thus, induction of urokinase by CGA and inhibition of PAI-1 by CPB, GE and TTB may, at least partly, account for the elevation of fibrinolytic activity of endothelial cells.
Assuntos
Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Fibrinólise/efeitos dos fármacos , Fibrinolíticos/farmacologia , Animais , Antibacterianos/química , Antibacterianos/farmacologia , Aorta/efeitos dos fármacos , Aorta/metabolismo , Benzofuranos/química , Benzofuranos/farmacologia , Bovinos , Células Cultivadas , Endotélio Vascular/citologia , Fibrinolisina/efeitos dos fármacos , Fibrinolisina/metabolismo , Fungos/metabolismo , Alcaloides Indólicos , Indóis/química , Indóis/farmacologia , Lactamas/química , Lactamas/farmacologia , Compostos Orgânicos , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Testes de Precipitina , Ativador de Plasminogênio Tipo Uroquinase/metabolismoRESUMO
PURPOSE: To evaluate the role of radiation therapy for adrenal metastases. MATERIALS AND METHODS: Fourteen patients, 13 with primary lung carcinoma and one with primary unknown carcinoma, received radiation therapy for adrenal metastases from 1984 to 1995 at the Hyogo Medical Center for Adults. Total dose ranged from 16 Gy to 60 Gy, and fractional dose from 1.6 Gy/ Fr to 3 Gy/Fr. RESULTS: Partial response of the local tumor was recognized in 2 of 7 patients by CT imaging. Pain relief was obtained in 7 of 8 patients. Median survival was 3 months, and 6-month survival was 28.6% in all patients. Among patients in the symptomatic group, who had complaints of pain due to adrenal mass, survival was even worse (12.5% at 6 months). There were no severe complications, but 4 patients (29%) had gastrointestinal symptoms. CONCLUSION: Radiation therapy is useful for the purpose of pain relief in adrenal metastases.
