RESUMO
BACKGROUND: Granular cell tumors occur in all ages and many anatomic sites. In the craniofacial region, they typically arise in soft tissue, not bone. We present a primary intra-osseous granular cell tumor of the sphenoid and central skull base arising in a 12- year- old girl. CASE REPORT: A 12-year-old female with sickle cell disease and Jeavons syndrome presented with seizures. Imaging and partial resection revealed an expansile benign granular cell tumor (GCT) involving the sphenoid body, pterygoid process, and central skull base. The disease has remained stable after 36-month follow up. DISCUSSION: GCT primarily involving the osseous sphenoid/skull base has not been previously reported in a child. Although mostly benign, some are aggressive, with malignant transformation in 1-2%. Surgery is the mainstay of treatment, but in the skull base this may be limited by adjacent critical structures. Decision-making is guided by anatomic extent, histology, and clinical behavior.
Assuntos
Tumor de Células Granulares , Neoplasias da Base do Crânio , Osso Esfenoide , Humanos , Feminino , Criança , Tumor de Células Granulares/patologia , Tumor de Células Granulares/diagnóstico , Tumor de Células Granulares/cirurgia , Osso Esfenoide/patologia , Neoplasias da Base do Crânio/patologia , Neoplasias da Base do Crânio/diagnóstico , Neoplasias da Base do Crânio/cirurgia , Anemia Falciforme/complicações , Anemia Falciforme/patologia , Base do Crânio/patologia , Base do Crânio/diagnóstico por imagemAssuntos
Neoplasias do Tronco Encefálico/radioterapia , Disfunção Cognitiva/virologia , Irradiação Craniana/efeitos adversos , Encefalite por Herpes Simples/etiologia , Glioma/radioterapia , Herpesvirus Humano 1/isolamento & purificação , Aciclovir/uso terapêutico , Antineoplásicos Alquilantes/uso terapêutico , Antivirais/uso terapêutico , Neoplasias do Tronco Encefálico/diagnóstico por imagem , Neoplasias do Tronco Encefálico/tratamento farmacológico , Disfunção Cognitiva/diagnóstico , Dacarbazina/análogos & derivados , Dacarbazina/uso terapêutico , Delírio/etiologia , Delírio/virologia , Dexametasona/uso terapêutico , Diagnóstico Diferencial , Encefalite por Herpes Simples/complicações , Encefalite por Herpes Simples/tratamento farmacológico , Feminino , Glioma/diagnóstico por imagem , Glioma/tratamento farmacológico , Humanos , Leucocitose/virologia , Imageamento por Ressonância Magnética , Convulsões/diagnóstico , Convulsões/virologia , Temozolomida , Adulto JovemRESUMO
The objective of this study was to evaluate the acute tolerance to definitive external-beam radiation therapy (RT; EBRT) in patients with prostate adenocarcinoma and HIV and to review the published literature for this population. Three patients with prostate adenocarcinoma and HIV were treated with definitive RT. Medical records were reviewed for prostate cancer and HIV characteristics, RT details, and acute toxicity. A review of the published literature was performed for epidemiology, management, and outcome of these patients. All 3 patients had excellent acute tolerance to definitive EBRT and, with short follow-up, all had decreasing prostate-specific antigen levels. The published literature regarding patients with prostate adenocarcinoma and HIV is scarce but suggests that men with HIV might be at higher risk of developing prostate cancer. External-beam radiation therapy, brachytherapy, and surgery have all been used in the management of these patients. All 3 patients with prostate adenocarcinoma and HIV had an excellent acute tolerance to EBRT. Prostate cancer is expected to become an increasingly important health problem for men infected with HIV as their life expectancy lengthens.
Assuntos
Adenocarcinoma/complicações , Adenocarcinoma/radioterapia , Infecções por HIV/complicações , Neoplasias da Próstata/complicações , Neoplasias da Próstata/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
The optimal dose of weekly docetaxel in combination with cisplatin and concomitant thoracic radiation therapy (XRT) in patients with locally advanced non-small cell lung cancer (NSCLC) is not well defined. The purpose of this study was to define the maximal tolerated dose (MTD) of docetaxel in this combination. Eligible patients had unresectable stage IIIA or IIIB NSCLC without pleural effusion. Treatment consisted of cisplatin 25 mg/m(2) plus docetaxel weekly and concomitant standard XRT for a total of 60 Gy at 200 cGy/fraction/day 5 times weekly for 6 weeks. The starting dose of docetaxel in the first cohort was 15 mg/m(2)/week. This dose was escalated by 5 mg/m(2) per cohort of 3 patients. No intrapatient dose escalation was allowed. The doses of cisplatin and XRT were not escalated. A total of 23 patients were enrolled, and 19 patients were evaluable for analysis. The first cohort (docetaxel 15 mg/m(2)/week) completed treatment without any Grade 3 or 4 toxicities. The second cohort (docetaxel 20 mg/m(2)/week) was expanded to 6 patients because of Grade 3 cough observed in 1 patient. One of 5 patients experienced Grade 3 esophagitis at the docetaxel 25 mg/m(2)/week dose level. Dose limiting toxicity consisting of Grade 3 esophagitis was reached in 4 of 5 patients receiving docetaxel at 30 mg/m(2)/week. This study determined the MTD of weekly docetaxel to be 25 mg/m(2) when combined with cisplatin 25 mg/m(2) and radiation therapy for locally advanced NSCLC. Further evaluation of this regimen in a phase II trial is underway.