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Neurological complications of cancer

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https://www.readbyqxmd.com/read/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#1
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28623118/derivation-and-validation-of-a-clinical-prediction-scale-for-isolated-distal-deep-venous-thrombosis-in-patients-after-acute-ischemic-stroke
#2
Sheng-Yun Li, Liang Feng, Mei-Juan Xiao, Si-Yan Chen, Jin-Cai He, Zhen Wang
BACKGROUND: Isolated distal deep venous thrombosis (IDDVT) is a common complication after ischemic stroke. However, there is a paucity of evidence regarding the clinical features and risk factors of IDDVT in patients with acute ischemic stroke. This study aimed to establish and validate a clinical prediction scale of IDDVT at an early stage of ischemic stroke development. METHODS: We retrospectively studied consecutive patients with stroke admitted to our neurology department between January and December 2016...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28616866/vocal-palsy-increases-the-risk-of-lower-respiratory-tract-infection-in-low-risk-low-morbidity-patients-undergoing-thyroidectomy-for-benign-disease-a-big-data-analysis
#3
S A R Nouraei, J Allen, H Kaddour, S E Middleton, P Aylin, A Darzi, N S Tolley
OBJECTIVES: Thyroidectomy is the commonest and most rapidly-growing operation which places normally-functioning laryngeal nerves at risk of injury. Laryngeal palsy is a major risk-factor for dysphonia, dysphagia, and less commonly, airway obstruction. We investigated the association between post-thyroidectomy vocal palsy and long-term risks of pneumonia and laryngeal failure. DESIGN: An N=near-all analysis of the English administrative dataset using a previously-validated informatics algorithm to identify young and otherwise low-risk patients undergoing thyroidectomy for benign disease...
June 14, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28588797/widespread-subdural-metastasis-from-breast-cancer-progressing-rapidly-with-cerebral-herniation-a-case-report
#4
Yoshiko Okita, Norikazu Masuda, Makiko Mizutani, Yoshinori Kodama, Kiyoshi Mori, Masayuki Mano, Tomoyoshi Nakagawa, Shin Nakajima, Toshiyuki Fujinaka
We herein present the case of a 49-year-old female patient presenting with nausea and headache. The patient's medical history included breast cancer with bone and lymph node metastasis. Computed tomography (CT) examination revealed a high-density lesion in the right subdural space, suggesting hematoma. During surgery planned for subdural hematoma drainage, an en plaque subdural yellowish-white tumor was identified, without hematoma. Histopathological examination revealed metastatic breast cancer. The patient was administered predonisolone and her neurological symptoms gradually recovered...
June 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28578306/multiple-recurrent-ischaemic-strokes-in-a-patient-with-cancer-is-there-a-role-for-the-initiation-of-anticoagulation-therapy-for-secondary-stroke-prevention
#5
Giselle Alexandra Suero-Abreu, Jia Zhen Cheng, Ryna Karina Then
A 52-year-old woman with a medical history of cervical and thyroid cancer, hypertension, dyslipidaemia, uncontrolled diabetes and heavy smoking was diagnosed with a new metastatic cholangiocarcinoma. While undergoing palliative chemotherapy, she developed dysarthria and left-sided weakness. Imaging studies showed multiple bilateral ischaemic strokes. On hospital days 2 and 5, she developed worsening neurological symptoms and imaging studies revealed new areas of ischaemia on respective days. Subsequent workup did not revealed a clear aetiology for the multiple ischaemic events and hypercoagulability studies were only significant for a mildly elevated serum D-dimer level...
June 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28576175/update-on-radiotherapy-for-central-nervous-system-malignancies
#6
REVIEW
Eric Kemmerer, Sunjay Shah
Malignancies arising from the central nervous system are rare. Brain metastases, in contrast, are perhaps the most common neurologic complication of cancer. Radiotherapy, as part of combined modality therapy, continues to evolve with the advancement of stereotactic radiosurgery indications, the addition of new technologies, such as alternating electric field therapy, and mounting advances in the complex biology of these entities. The explosion of new clinical trials combined with newly discovered molecular markers suggest the beginning of a paradigm shift in the management of these challenging malignancies that will allow for future risk-stratification strategies...
July 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28565897/management-of-patients-with-an-unruptured-intracranial-aneurysm-and-a-history-of-malignancy
#7
Ondra Petr, Anthony M Burrows, Waleed Brinjikji, Robert D Brown, Giuseppe Lanzino
BACKGROUND: Management of a patient with an unruptured intracranial aneurysm (UIA) who has a history of malignancy can be challenging due to considerations related to the natural history of the aneurysm and risk of recurrence or progression of malignancy. The current study presents our experience with both conservative management and interventional treatment of patients with UIAs and a remote or recent history of cancer. METHODS: Consecutive patients with a history of malignancy and UIA were classified into the following groups: Group I (diagnoses of both UIA and cancer within 3 years) and Group II (known cancer with new UIA diagnosed ≥ 3 years after cancer)...
May 31, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28539034/-the-short-term-outcome-and-safety-of-laparoscopic-colorectal-cancer-resection-in-very-elderly-patients
#8
Won Beom Jung, Jin Yong Shin, Byoung Jo Suh
Background/Aims: Due to the recent increase in elderly population, laparoscopic surgery is more frequently performed in the elderly. This study aimed to compare the short-term outcomes of laparoscopic colorectal cancer surgery between the very elderly group (VEG), categorized as those with age over 80 years and the elderly group (EG), categorized as those with age 65 to 79 years. Methods: We retrospectively compared 48 very elderly patients with 96 elderly patients (1:2 matched) who underwent laparoscopic resection for colorectal cancers at our institution between March 2010 and December 2014...
May 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28508764/current-incidence-of-different-morphological-types-of-malignant-metastases-to-the-spine-based-on-magnetic-resonance-imaging
#9
Grzegorz Guzik
BACKGROUND: Malignant tumours particularly often metastasise to the spine, causing considerable pain and limiting the patient's physical function. Standard therapy consists in surgical treatment with adjuvant radiotherapy. The qualification for surgery is a multifaceted process and detailed analysis of the morphology of the metastasis is a key factor. Numerous types of classification of metastatic lesions exist, among which the Tomita system, based on MRI findings, appears to be the most practical...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28495807/neurologic-serious-adverse-events-associated-with-nivolumab-plus-ipilimumab-or-nivolumab-alone-in-advanced-melanoma-including-a-case-series-of-encephalitis
#10
James Larkin, Bartosz Chmielowski, Christopher D Lao, F Stephen Hodi, William Sharfman, Jeffrey Weber, Karijn P M Suijkerbuijk, Sergio Azevedo, Hewei Li, Daniel Reshef, Alexandre Avila, David A Reardon
BACKGROUND: Despite unprecedented efficacy across multiple tumor types, immune checkpoint inhibitor therapy is associated with a unique and wide spectrum of immune-related adverse events (irAEs), including neurologic events ranging from mild headache to potentially life-threatening encephalitis. Here, we summarize neurologic irAEs associated with nivolumab and ipilimumab melanoma treatment, present cases of treatment-related encephalitis, and provide practical guidance on diagnosis and management...
June 2017: Oncologist
https://www.readbyqxmd.com/read/28492341/implications-of-neurovascular-uncoupling-in-functional-magnetic-resonance-imaging-fmri-of-brain-tumors
#11
Rebecca W Pak, Darian H Hadjiabadi, Janaka Senarathna, Shruti Agarwal, Nitish V Thakor, Jay J Pillai, Arvind P Pathak
Functional magnetic resonance imaging (fMRI) serves as a critical tool for presurgical mapping of eloquent cortex and changes in neurological function in patients diagnosed with brain tumors. However, the blood-oxygen-level-dependent (BOLD) contrast mechanism underlying fMRI assumes that neurovascular coupling remains intact during brain tumor progression, and that measured changes in cerebral blood flow (CBF) are correlated with neuronal function. Recent preclinical and clinical studies have demonstrated that even low-grade brain tumors can exhibit neurovascular uncoupling (NVU), which can confound interpretation of fMRI data...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28492105/metastatic-spinal-cord-compression-as-the-first-sign-of-malignancy
#12
Johan Wänman, Pawel Grabowski, Helena Nyström, Patrik Gustafsson, Anders Bergh, Anders Widmark, Sead Crnalic
Background and purpose - Metastatic spinal cord compression (MSCC) as the initial manifestation of malignancy (IMM) limits the time for diagnostic workup; most often, treatment is required before the final primary tumor diagnosis. We evaluated neurological outcome, complications, survival, and the manner of diagnosing the primary tumor in patients who were operated for MSCC as the IMM. Patients and methods - Records of 69 consecutive patients (51 men) who underwent surgery for MSCC as the IMM were reviewed...
May 11, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28490684/-cerebral-venous-sinus-thrombosis-following-cisplatin-based-chemotherapy-for-testicular-tumor
#13
Manabu Ishihara, Koichi Satoh, Mami Hanaoka, Kazuhito Matsuzaki, Taku Matsuda, Hajimu Miyake, Hitoshi Niki
A man in his 30s who presented with an enlarged right testicle was diagnosed with a germ cell tumor via orchiectomy. Adjuvant chemotherapy with cisplatin, etoposide and bleomycin(BEP)was initiated. He developed a headache 8 days later, followed by neurological deficits 10 days later. Magnetic resonance imaging(MRI)and magnetic resonance venography(MRV)showed thrombotic occlusion at the superior sagittal sinus. Anticoagulant therapy with heparin was initiated. However, a generalized epileptic seizure occurred 11 days later, and an antiepileptic drug therapy was initiated...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28469500/lung-adenocarcinoma-presenting-as-worsening-of-chronic-neck-pain-a-cautionary-tale
#14
Neeka N Akhavan, Tony S Brar, Edlira Maska
INTRODUCTION: Neck pain is a common musculoskeletal problem that up to 70% of the world population will experience at some point in their lives. Intramedullary spinal cord metastasis is an exceedingly rare complication of malignancy that affects less than 1% of all patients with cancer. CASE REPORT: We report a case of a 61-year-old man who presented to primary care clinic with 1-month history of worsening neck pain with associated neurologic deficits. Despite initial conservative management, the patient continued to have progressive worsening of sensory and motor deficits...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28458959/preoperative-radiotherapy-is-not-associated-with-increased-post-mastectomy-short-term-morbidity-analysis-of-77-902-patients
#15
Pablo A Baltodano, Myrna Eliann Reinhardt, José M Flores, Francis M Abreu, Anmol Chattha, Lyonell Kone, Carisa M Cooney, Michele A Manahan, Richard C Zellars, Gedge D Rosson
BACKGROUND: Neoadjuvant radiotherapy (NRT) enhances breast-conserving surgery outcomes, reducing local recurrence of breast cancer and increasing median survival. However, its effect on postoperative morbidity remains under-studied. We sought to assess the impact of NRT on 30-day postoperative morbidity after mastectomy. METHODS: We analyzed data from women undergoing mastectomy (with or without immediate reconstruction) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) 2005-2011 datasets...
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28449529/do-hospitals-need-oncological-critical-care-units
#16
EDITORIAL
Abby Koch, William Checkley
Since the inception of critical care as a formal discipline in the late 1950s, we have seen rapid specialization to many types of intensive care units (ICUs) to accommodate evolving life support technologies and novel therapies in various disciplines of medicine. Indeed, the field has expanded such that specialized ICUs currently exist to address critical care problems in medicine, cardiology, neurology and neurosurgery, trauma, burns, organ transplant and cardiothoracic surgeries. Specialization does not only need new infrastructure, but also training and staffing of health care providers, ancillary staff, and development and implementation of processes of care...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28436378/outcomes-of-corpectomy-in-patients-with-metastatic-cancer
#17
Grzegorz Guzik
BACKGROUND: The objective of surgical management of spinal metastases is to reduce pain and improve the patient's quality of life. The operation should restore spinal stability and decompress neural structures. One surgical technique is corpectomy followed by vertebral body reconstruction and stabilisation of the spine. The procedure may be performed in patients in overall good health and a good survival prognosis. The aim of this paper is to present the outcomes of surgical management of spinal metastases in patients who underwent corpectomy followed by vertebral body reconstruction and stabilisation of the spine...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28433114/hepatic-features-of-wilson-disease
#18
Salih Boga, Aftab Ala, Michael L Schilsky
In Wilson disease (WD) defective AT7B function leads to biliary copper excretion and pathologic copper accumulation, particularly in liver and brain, where it induces cellular damage. Liver disease most often precedes neurologic or psychiatric manifestations. In most patients with neurologic or psychiatric symptoms there is some degree of liver disease at the time of disease presentation. Hepatic manifestations of WD can be extremely variable. Patients with clinically asymptomatic WD are often found by family screening or identified on routine laboratory testing...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28431612/xeroderma-pigmentosum-complementation-group-f-a-rare-cause-of-cerebellar-ataxia-with-chorea
#19
G Carré, C Marelli, M Anheim, C Geny, M Renaud, H R Rezvani, M Koenig, C Guissart, C Tranchant
The complementation group F of Xeroderma pigmentosum (XP-F) is rare in the Caucasian population, and usually devoid of neurological symptoms. We report two cases, both Caucasian, who exhibited progressive cerebellar ataxia, chorea, a mild subcortical frontal cognitive impairment, and in one case severe polyneuropathy. Brain MRI demonstrated cerebellar (2/2) and cortical (1/2) atrophy. Both patients had only mild sunburn sensitivity and no skin cancer. Mini-exome sequencing approach revealed in ERCC4, two heterozygous mutations, one of which was never described (c...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28405535/signet-cell-in-the-brain-a-case-report-of-leptomeningeal-carcinomatosis-as-the-presenting-feature-of-gastric-signet-cell-cancer
#20
Saeed Ali, Muhammad Talha Khan, Evgeny A Idrisov, Aadil Maqsood, Fnu Asad-Ur-Rahman, Khalid Abusaada
Malignant infiltration of pia and arachnoid mater, referred to as leptomeningeal carcinomatosis (LMC), is a rare complication of gastric carcinoma. The most common underlying malignancy in patients with LMC are leukemia, breast cancer, lymphoma, and lung cancer. We report a case of gastric adenocarcinoma that presented with LMC in the absence of overt gastrointestinal signs or symptoms. A 56-year-old Hispanic woman presented to the hospital with a three-week history of intermittent headaches and visual blurring...
March 7, 2017: Curēus
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