[Intraabdominal paraganglioma--case report]. / Paragangliom intraabdominal--prezentare de caz.

Paraganglioma is a rare neuroendocrine neoplasm that may develop in the head, neck, torax or abdomen, with a not specified symptoms and the accurate diagnose is established histopathological. The authors present a case of one intraabdominal paraganglioma, incidentally found during ultrasonographic evaluation and diagnose with histopathological examination of excised pieces.

[Gastric cystic duplication--case report]. / Duplicatia chistica gastrica--prezentare de caz.

Gastrointestinal duplication is a rare surgical pathology, with unspecified symptoms, which explains why these malformations are difficult to diagnose correctly before surgery. The authors present a case of a gastric cystic duplication, that was diagnosed before surgery, as a pancreatic pseudocyst. The accurate diagnosis was established by surgery and based on histopathological examination.

[Precocious diagnosis in children's intussusception--a necessity]. / Diagnosticul precoce în invaginatia intestinala la sugar si copil--o necesitate.

Intussusception is the most common cause of intestinal obstruction in children. Despite the fact that this is a frequent and well known disease, sometimes clinical presentation is various and difficult to interpret, which leads to delay in diagnosis and treatment. Late treatment will sometimes require intestinal resection, with high morbidity and mortality. There are no laboratory tests useful in diagnosis of intussusception. The only diagnosis tools are history, ultrasound and radiology. We retrospectively reviewed medical files of 30 patients, admitted and treated for intussusception in Children Hospital Cluj-Napoca and underline the importance of early diagnosis and treatment. There is a connection between onset of the disease, presentation, treatment (conservative or surgical), complications and hospital stay.

Quality of life and treatment related toxicity in 335 patients with locally advanced cervical carcinoma treated by two chemoradiation regimens.

PURPOSE: Concomitant chemoradiotherapy (CT/RT) is the gold standard for advanced cervical carcinoma, but with frequent debates over treatment schedules and toxicity. This study compared 2 concomitant CT/RT regimens in terms of quality of life (QoL) and acute toxicity. PATIENTS AND METHODS: Between March 2003 and March 2005, 335 patients with stage IIB-IIIB cervical carcinoma were evaluated in a randomized single-center phase III trial at the Oncology Institute Cluj-Napoca. Patients received concurrent CT/RT with cisplatin 20 mg/m(2), days 1-5, every 21 days (arm A, n=171) or 40 mg/m(2)/weekly (arm B, n=164). QoL was estimated using the EORTC QLQ-30, v.3.0 questionnaire and acute toxicity using the common toxicity criteria (CTC) v.2.0. RESULTS: Significant improvement of global health status (p <0.01) and a decrease in pain (p <0.01) was observed in arm A. In arm B fatigue increased (p=0.01) and role functioning diminished (p=0.05). In both arms depression, nausea, vomiting and diarrhea increased (p <0.05). Gastrointestinal toxicity was similar in both arms (76% vs. 77.5%). Hemoglobin drop was higher in arm B: 75% vs. 63% (p=0.02), while no differences were seen in leukocyte and platelet toxicity. CONCLUSION: Concomitant CT/RT with cisplatin 20 mg/m(2) x 5 days every 21 days has better impact on patients' QoL and lower toxicity compared with the weekly chemotherapy regimen.

Clinical results of medium dose rate brachytherapy combined with external beam radiotherapy in the treatment of advanced cervical carcinoma.

PURPOSE: To evaluate the overall and disease-free survival of patients with advanced cervical carcinoma (FIGO stages IIB-IIIB) treated with external beam radiotherapy (EBRT) and medium dose rate brachytherapy (MDR-BT) plus/minus surgery. PATIENTS AND METHODS: One hundred and seven patients received preoperative RT (group A) and 154 were treated with definitive RT (group B); 73 patients in both groups also received cisplatin as radiosensitizer. EBRT delivered as preoperative reached a total dose of 44-46 Gy/pelvis, whereas the definitive RT reached a total dose of 62-64 Gy with standard fractionation. MDR-BT was performed with a LDR/MDR Cs-137 Selectron machine; 10 Gy/point A were delivered in the preoperative group A and 14 Gy/point A/, 1-2 fractions in group B. Cisplatin as radiosensitizer was administered during EBRT at a dose of 20 mg/m(2)/day for 5 days with 21 days interval between cycles. RESULTS: With a median follow-up of 44.4 months (range 3.4-61.6) the overall survival at 3 years in group A was 92% vs. 68% for group B (p<0.01). According to FIGO stages 3-year overall survival was 88% in stage IIB, 79% in IIIA and 60% in IIIB (p<0.01). Three-year local control was 73.5% (192 patients). Thirty-three (13%) patients developed locoregional recurrences, and another 8 (3.07%) locoregional recurrences plus distant metastases. CONCLUSION: The association of EBRT with MDR-BT represents an effective treatment in advanced cervical carcinoma. A significant difference in 3-year overall survival was found, favoring preoperative RT, with a very good rate of local control.