Paliative Care Case

BACKGROUND: Bone metastases are frequent in patients with cancer. Electrochemotherapy (ECT) is a minimally invasive treatment based on a high-voltage electric pulse combined with an anticancer drug. Preclinical and clinical studies supported the use of ECT in patients with metastatic bone disease, demonstrating that it does not damage the mineral structure of the bone and its regenerative capacity, and that is feasible and efficient for the treatment of bone metastases. Year 2014 saw the start of a registry of patients with bone metastases treated with ECT, whose data are recorded in a shared database...

Merkel cell carcinoma is a highly aggressive neuroendocrine skin tumor. This type of tumor is primarily based on Merkel cells located in the basal layer of the epidermis. The tumor occurs predominantly in elderly individuals (average age 69 years) and has a strong tendency to local recurrence and locoregional metastasis. Diagnosis of the tumor is based on histological and immunohistochemical examination. The therapy is radical surgery followed by adjuvant radiotherapy to the site of the primary tumor and regional lymph nodes...

The aim of the study is determine, that transhepatic,transcutaneal drainage of the bile ducts is the method of palliative treatment of inoperative liver hilum tumours. In the years 1998-2011, 211 patients with malignant obturation of the liver hilum were palliative treated by transcutanel, transhepatic drainage with US control. Patients with inoperative, malignant tumours of liver hilum in terminal state were included. More than 5 mm, minimal wideness of bile duct was the main term of qualification to procedure...

UNLABELLED: Cholangiocarcinomas have been often met in daily practice. Biliar tract neoplasmas are the most important group in adenomas and papillomas. There is the medical and social problem with cancer patients because they call doctor too late when cancer changes reach a high level and only paliative procedures are recommended. In the most cases the prothesis implanted by ERCP and surgical digestive bypasses are applied. AIM OF THE STUDY: was to evaluate some therapeutic methods in paliative treatment applied in patients with biliary tract cancer...

Gastric carcinoma is a malignancy, frequently manifesting itself in late stages, with metastatic spread into lymph nodes. Resection is the only curative therapy. A total of 149 gastric carcinoma patients were operated in the Ist Surgical Clinic during the studied five- year period. The pre-operative disease staging included the PET-CT examination, as a standard. Total gastrectomy (GE) was completed in 109 subjects, while 12 subjects underwent subtotal GE. The both procedures included D2 lymphadenectomy. In selected cases, the surgery included upper polar resection (7 subjects)...

AIM: This case study reports an occurence of a mammary gland carcinoma in woman during her pregnancy and puerperium. CASE REPORT: Patient was 29 years old woman, without any familiar or personal history of cancer or cancer risk factors. There was a finding of palpable resistance in the lateral superior quadrant of right breast in 30 week of gestation, which was considered to be hormonal changes in pregnancy. The third day after delivery a breast ultrasonography was performed because of persisting mastodynia, moderate oedema in described area and resistance nonresponding to the typical finding in period of incipient lactation...

Paliative surgery in carcinoma of the head of the pancreas have thoroughly task to carry out decompression of biliar tract, remove duodenal impassability and reduce the pain. Numerous variants for decompression of biliar tract were recommended, but stil now there is no agreement about optimal approach. As method of choise for decompression of biliar tract in patients with cancer our first alternative is making safeless, with little traumatic and easy performance anastomosis. Duodenostasis in patients with carcinoma of the head of the pancreas was determinated clinicly in 40-60% of casees...

UNLABELLED: Pancreatic cancer is a great surgical problem. Clinical observations confirm 10-15% level of R0 resection ability. Dissatisfying treatment effects results from: lach of simple screening tests, low specificity of methods used to diagnose less than 2 cm lesions, low availability of advanced diagnostic methods (endoscopic ultrasonography), anatomy of pancreatoduodenic area, ability of infiltration adhering structures and causing metastatic tumors. AIM: Retrospective evaluation of treatment methods administered to patients with pancreatic cancer according to different clinical stages...

AIM: A retrospective assessment of the post-surgical and long-term results of the high biliodigestive anastomoses constructed using the authors' own technique modification. METHODOLOGY: This study evaluates 25 patient cases during an 8-year-period. The patients had high biliodigestive anastomosis affixed due to the clinically manifested obstructive icterus or due to repetitive attacks of cholangitides. The underlying causes of the attacks were malignancies of the ductus hepatocholedochus in 13 cases, a stricture of the ductus hepatocholedochus following the drainage according to Kehr in 1 case, an inflammative stenosis of the ductus hepatocholedochus during choledocholithiasis in 1 case, the Mirizzi syndrome in 2 cases, a cyst of the ductus hepatocholedochus in 2 cases, a stricture of the ductus hepatocholedochus following choledochoduodenoanastomosis in 4 cases, hepaticolithiasis in 1 case, a status after cholecystogastrostomy in 1 case, and a status after ductus hepatocholedochus contusion in 1 case...

The article describes treatment results of 1228 patients operated on because of different forms of pulmonary tuberculosis. According to spreading of tuberculosis and developed complications in spite of the medicamental treatment the patients were divided in to two clinical groups. The first group included 417 patients with direct indications for surgery. The second group included 811 patients with complications of pulmonary tuberculosis (with spontaneous pneumothorax - 237, spontaneous pyopneumothorax - 170, tuberculous pleural empyema - 271, pulmonary hemorrhage - 105, with pulmonary reoperations - 28)...

The aim of study was presentation of our experiences in diagnosis and treatment in pancreatic carcinoma in confrontation with current opinions. Between 1984-1995 at our Department was treated 211 patients with carcinoma of exocrine part of the pancreas. It were 137 male and 74 female with mean age 58.9 years. In 151 cases (70.5%) primary seat of tumour was located in the head and in 60 cases (29.5.1%) in the body or tail of pancreas. The diagnosis was determined on the basis of clinical symptoms and laboratory investigation Diagnostic accuracy of X-ray investigations was as follow: Ultrasonography-86%, CT-scan-91%, ERCP-94%...

Preoperative evaluation of esophageal cancer is fundamental to assess the degree of extension of the tumor and operability. Surgery remains the reference treatment for tumors with limited loco-regional extension. The prognosis depends on the degree of mural infiltration and lymph node involvement. Adjuvant chemotherapy or radiotherapy does not improve survival in randomized trials. In case of inoperability, good paliation can be achieved by electrocoagulation, laser or endoprosthesis, possibly combine with chemotherapy...