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https://www.readbyqxmd.com/read/28730256/advanced-metastatic-breast-cancer-in-pregnancy-the-imperative-of-physical-breast-examination-in-pregnancy
#1
Anca Angela Simionescu, Claudia Valentina Georgescu, Mirela Corina Ghiluşi, Sabrina Ioana Stoica, Mircea Dragoş Median
Breast cancer is the most frequent cancer diagnosed among women; its association with pregnancy is not encountered. As childbearing age is increasing, the diagnosis of breast cancer associated pregnancy tends to be more often than years ago. Here we report a case of a 37-year-old patient, gravida 7, para 7, diagnosed at 30 weeks gestation with metastatic breast cancer. The patient presented to hospital due to an altered performance status. Obstetrical evaluation was within normal range. A metastatic infiltrating breast cancer poorly differentiated (G3) with satellite skin lesions (T4b), ipsilateral axillary and supraclavicular lymph nodes (N3), lung metastasis bilateral with pleural effusion and hepatic metastasis (M1), were diagnosed...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28727717/percutaneous-vertebroplasty-for-primary-non-hodgkin-s-lymphoma-of-the-thoracic-spine-case-report-and-review-of-the-literature
#2
Pu Jia, JinJun Li, Hao Chen, Li Bao, Fei Feng, Hai Tang
Primary non-Hodgkin's lymphoma of the vertebra is rare in the spine of the elderly. The clinical presentation and radiological features are unspecific, which make it more difficult for diagnosis. We report a case of a 79-year-old woman complaining of serious backache without any injury. The magnetic resonance imaging (MRI) showed invasion of the fifth thoracic vertebra with the posterior vertebral body wall defect. There was a high suspicion that the patient had a metastatic tumor of the vertebra. A percutaneous vertebroplasty was performed under fluoroscopic guidance, which was used to treat the osteoporotic vertebral compression fracture, vertebral metastases, verte-bral hemangioma, and multiple myeloma...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28719452/treatment-of-spinal-tumors-in-a-high-volume-center-has-direct-impact-on-local-recurrence-morbidity-and-mortality
#3
Ran Lador, Stefano Bandiera, Alessandro Gasbarrini, Riccardo Ghermandi, Stefano Boriani
OBJECTIVE OF THE STUDY: En bloc resections of spine tumors aim at locally controlling the disease for both improving the patient's quality of life as well as improving mortality. The purpose of this study was to compare the outcome between patients who were initially treated in a high volume specialized center, and patients who initially underwent either invasive diagnostic procedure or an initial surgical attempt to treat the disease in a different center. MATERIALS AND METHODS: A retrospective study of 1681 patients affected by spine tumors-treated from 1990 to 2015 by the same team...
July 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28713049/patient-reported-outcomes-after-surgical-stabilization-of-spinal-tumors-symptom-based-validation-of-the-spinal-instability-neoplastic-score-sins-and-surgery
#4
Ibrahim Hussain, Ori Barzilai, Anne S Reiner, Natalie DiStefano, Lily McLaughlin, Shahiba Ogilvie, Mark Bilsky, Ilya Laufer
BACKGROUND CONTEXT: Neoplastic spinal instability is movement-related pain or neurologic compromise under physiologic loads with the Spinal Instability Neoplastic Score (SINS) developed to facilitate diagnosis. There is a paucity of evidence that mechanical instability correlates with patient-reported symptoms and that surgical stabilization significantly improves these patient-reported outcomes (PRO). PURPOSE: The objective of this study was to determine if SINS correlates with patient-reported preoperative pain and disability and if surgical stabilization significantly improves PRO...
July 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28698408/dose-escalation-by-image-guided-intensity-modulated-radiotherapy-leads-to-an-increase-in-pain-relief-for-spinal-metastases-a-comparison-study-with-a-regimen-of-30-gy-in-10-fractions
#5
Jinlan He, Jianghong Xiao, Xingchen Peng, Baofeng Duan, Yan Li, Ping Ai, Min Yao, Nianyong Chen
PURPOSE: Under the existing condition that the optimum radiotherapy regimen for spinal metastases is controversial, this study investigates the benefits of dose escalation by image-guided intensity-modulated radiotherapy (IG-IMRT) with 60-66 Gy in 20-30 fractions for spinal metastases. RESULTS: In the dose-escalation group, each D50 of planning gross tumor volume (PGTV) was above 60 Gy and each Dmax of spinal cord planning organ at risk volume (PRV) was below 48 Gy...
July 4, 2017: Oncotarget
https://www.readbyqxmd.com/read/28694595/minimally-invasive-separation-surgery-plus-adjuvsant-stereotactic-radiotherapy-in-the-management-of-spinal-epidural-metastases
#6
Mazda K Turel, Mena G Kerolus, John E O'Toole
AIM: This study aimed to describe the application of minimally invasive surgery (MIS) in separation surgery combined with postoperative stereotactic body radiation therapy (SBRT) in patients with symptomatic metastatic epidural spinal disease. METHODS: Three techniques are described: (1) MIS posterior separation surgery alone, (2) MIS posterolateral separation surgery with percutaneous pedicle screw placement, and (3) MIS lateral corpectomy with percutaneous pedicle screw placement...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28673383/preoperative-embolization-in-surgical-treatment-of-metastatic-spinal-cord-compression
#7
Caroline Clausen
An increasing number of patients develop symptomatic spinal metastasis and increasing evidence supports the benefit of surgical decompression and spinal stabilization combined with radiation therapy. However, surgery for metastatic spinal disease is known to be associated with a risk of substantial intraoperative blood loss and perioperative allogenic blood transfusion. Anemia is known to increase morbidity and mortality in patients undergoing surgery, but studies also indicate that transfusion with allogenic red blood cells (RBC) may lead to worse outcomes...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28660109/usefulness-of-tokuhashi-score-in-survival-prediction-of-patients-operated-for-vertebral-metastatic-disease
#8
Marcelo Gruenberg, Maximiliano E Mereles, Gastón O Camino Willhuber, Marcelo Valacco, Matias G Petracchi, Carlos A Solá
STUDY DESIGN: Retrospective study. OBJECTIVE: Spinal metastasis can produce pain, deformity, neurological compromise and can decrease life expectancy. Surgical management is usually indicated for pain control, neurological decompression, and to avoid deformity progression. Tokuhashi et al created a scoring system to estimate survival and stratify surgical treatment based on established parameters. Our objective was to evaluate the usefulness of Tokuhashi scoring (TS) system by comparing the predicted and real survival times and analyze the survival time according to the type of tumor...
May 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28644075/spine-stereotactic-radiosurgery-for-metastatic-sarcoma-patterns-of-failure-and-radiation-treatment-volume-considerations
#9
Andrew J Bishop, Randa Tao, B Ashleigh Guadagnolo, Pamela K Allen, Neal C Rebueno, Xin A Wang, Behrang Amini, Claudio E Tatsui, Laurence D Rhines, Jing Li, Eric L Chang, Paul D Brown, Amol J Ghia
OBJECTIVE Given the relatively lower radiosensitivity of sarcomas and the locally infiltrative patterns of spread, the authors sought to investigate spine stereotactic radiosurgery (SSRS) outcomes for metastatic sarcomas and to analyze patterns of failure. METHODS The records of 48 patients with 66 sarcoma spinal metastases consecutively treated with SSRS between 2002 and 2013 were reviewed. The Kaplan-Meier method was used to estimate rates of overall survival (OS) and local control (LC). Local recurrences were categorized as occurring infield (within the 95% isodose line [IDL]), marginally (between the 20% and 95% IDLs), or out of field...
June 23, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28640703/integrating-evidence-based-medicine-for-treatment-of-spinal-metastases-into-a-decision-framework-neurologic-oncologic-mechanicals-stability-and-systemic-disease
#10
Ori Barzilai, Ilya Laufer, Yoshiya Yamada, Daniel S Higginson, Adam M Schmitt, Eric Lis, Mark H Bilsky
Patients with cancer are frequently affected by spinal metastases. Treatment is palliative, with the principle goals of pain relief, preservation of neurologic function, and improvement in quality of life. In the past decade, we have witnessed a dramatic change in the treatment paradigms due to the development of improved surgical strategies and systemic and radiation therapy. The most important change to these paradigms has been the integration of spinal stereotactic radiosurgery (SSRS), allowing delivery of tumoricidal radiation doses with sparing of nearby organs at risk...
July 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28606580/comparison-of-operative-time-with-conventional-fluoroscopy-versus-spinal-neuronavigation-in-instrumented-spinal-tumor-surgery
#11
James A Miller, Andrew J Fabiano
OBJECTIVE: Spinal neuronavigation improves accuracy of pedicle screw placement but may increase operative time, and its use in oncological operations remains relatively unstudied. We compared the use of 2-dimensional (2D) fluoroscopy and 3-dimensional (3D) spinal neuronavigation relative to operative time in instrumented oncology procedures. METHODS: Consecutive instrumented oncologic spinal operations for multiple myeloma or metastatic disease performed between 2012 and 2014 were retrospectively reviewed...
June 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28587057/safety-and-efficacy-of-stereotactic-ablative-radiation-therapy-for-renal-cell-carcinoma-extracranial-metastases
#12
Chiachien Jake Wang, Alana Christie, Mu-Han Lin, Matthew Jung, Derek Weix, Lorel Huelsmann, Kristin Kuhn, Jeffrey Meyer, Neil Desai, D W Nathan Kim, Ivan Pedrosa, Vitaly Margulis, Jeffrey Cadeddu, Arthur Sagalowsky, Jeffrey Gahan, Aaron Laine, Xian-Jin Xie, Hak Choy, James Brugarolas, Robert Timmerman, Raquibul Hannan
PURPOSE: Renal cell carcinoma is refractory to conventional radiation therapy but responds to higher doses per fraction. However, the dosimetric data and clinical factors affecting local control (LC) are largely unknown. We aimed to evaluate the safety and efficacy of stereotactic ablative radiation therapy (SAbR) for extracranial renal cell carcinoma metastases. METHODS AND MATERIALS: We reviewed 175 metastatic lesions from 84 patients treated with SAbR between 2005 and 2015...
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28577828/stereotactic-body-radiotherapy-in-the-treatment-of-spinal-metastases
#13
REVIEW
Evangelia Katsoulakis, Kiran Kumar, Ilya Laufer, Yoshiya Yamada
Patients with metastatic disease including polymetastatic, oligometastatic, and oligorecurrent spinal lesions have extended life expectancy secondary to improvements in systemic agents, and thus require durable local control of spine metastases. Stereotactic body radiotherapy (SBRT), which uses highly conformal treatment planning techniques coupled with image-guided technology, has enabled the safe delivery of tumor-ablative doses of radiotherapy. The NOMS decision framework has been developed as a tool to aid in the determination of the optimal treatment of spinal metastases, incorporating radiosurgery, separation surgery, stabilization techniques, and conventional radiation...
July 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28570482/targeting-the-s1p-s1pr1-axis-mitigates-cancer-induced-bone-pain-and-neuroinflammation
#14
Shaness A Grenald, Timothy M Doyle, Hong Zhang, Lauren M Slosky, Zhoumou Chen, Tally M Largent-Milnes, Sarah Spiegel, Todd W Vanderah, Daniela Salvemini
Metastatic bone pain is the single most common form of cancer pain, and persists as a result of peripheral and central inflammatory, as well as, neuropathic mechanisms. Here, we provide the first characterization of sphingolipid metabolism alterations in the spinal cord occurring during cancer-induced bone pain (CIBP). Following femoral arthrotomy and syngenic tumor implantation in mice, ceramides decreased with corresponding increases in sphingosine and the bioactive sphingolipid metabolite, sphingosine 1-phosphate (S1P)...
May 31, 2017: Pain
https://www.readbyqxmd.com/read/28564663/current-treatment-of-metastatic-spine-tumors-surgery-and-stereotactic-radiosurgery
#15
Jared S Fridley, Jaroslaw T Hepel, Adetokunbo A Oyelese
There has been significant progress and innovation in the treatment of patients with metastatic spinal tumors over the last two to three decades that has impacted our ability to provide individualized care that improves a patient's quality of life and degree of neurologic impairment. Advances in surgical techniques and radiation delivery modalities have dramatically improved our ability to decrease local tumor recurrence rates, improve pain control, and provide more durable spinal stability. Modern day spine tumor resection and reconstruction techniques have been shown to improve and prolong patients' ability to ambulate, maintain continence, and reduce the need for pain medications...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28558111/clinical-results-of-minimally-invasive-spine-stabilization-for-spinal-metastases
#16
Hiroshi Uei, Yasuaki Tokuhashi, Masashi Oshima, Masafumi Maseda, Koji Matsumoto, Hirotoki Soma, Enshi Nakayama, Yuichiro Tachikawa
The goal of the study was to evaluate minimally invasive palliative surgery and the effect of postoperative adjuvant therapy for metastatic spinal tumor with a limited vital prognosis. Of the 70 patients who underwent palliative surgery for metastatic spinal tumor at the authors' hospital between March 2012 and May 2016, thirty-three were treated with minimally invasive spine stabilization (MISt) using percutaneous pedicle screws (PPSs) and included in the current study. Of the 33 patients, 26 were men and 7 were women; mean age at surgery was 68...
July 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28544780/spinal-metastatic-disease-a-review-of-the-role-of-the-multidisciplinary-team
#17
REVIEW
Mark Curtin, Robert P Piggott, Evelyn P Murphy, Sudarshan Munigangaiah, Joseph F Baker, John P McCabe, Aiden Devitt
Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database review including pertinent articles exploring the multidisciplinary management of spinal metastatic disease. The wide variation in clinical presentation and tumor response to treatment necessitates a multidisciplinary approach that integrates the diagnosis and treatment of the cancer, symptom management, and rehabilitation for optimal care of patients with spinal metastases...
May 24, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28533876/-surgical-treatment-of-spinal-bone-metastases
#18
REVIEW
Abderrazzak El Saqui, Mohamed Aggouri, Mohamed Benzagmout, Khalid Chakour, Mohamed El Faiz Chaoui
Surgery for metastatic tumor is usually a palliative surgery, especially for spinal metastases, due to their anatomical localization. Surgical procedure should be accurately established to have simple outcomes and to start adjuvant treatment as soon as clinically possible. Therapeutic strategy should proceed after multidisciplinary consultation meeting (RCP). The main risk of spinal bone metastases is neurological, hence this surgery should be most commonly preventive. Its main objective is to improve patient's quality of life...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28529579/expression-and-correlation-analysis-of-regiv-and-vascular-endothelial-growth-factors-vegf-a-and-vegf-c-in-metastatic-spinal-tumors
#19
Shuquan Zhang, Guanjie Zhao, Yi Zhao, Rui Gu, Chuangang Peng, Zhe Pu, Minfei Wu
The expression and correlation analysis of the regenerating gene family member 4 (RegIV) and vascular endothelial growth factors (VEGF-A and VEGF-C) in metastatic spinal tumors were studied. Fifteen patients with metastatic spinal tumors who underwent operation in our hospital from January 2011 to January 2013 were selected into this study. The expression level of tumor tissues in patients with spinal metastasis and RegIV, VEGF-A and VEGF-C of the corresponding paracancer normal tissue samples were evaluated by immunohistochemical staining method and the correlation between the expression of RegIV, VEGF-A and VEGF-C was analyzed...
May 2017: Oncology Letters
https://www.readbyqxmd.com/read/28505957/spindle-cell-type-malignant-peripheral-nerve-sheath-tumor-arising-in-benign-schwannoma-with-multiple-intraosseous-spinal-metastasis-a-case-report
#20
Jae Yoon Chung, Sung Sun Kim, Sung Kyu Kim
BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) arising in benign schwannoma with multiple intraosseous spinal metastasis is extremely rare, having a highly aggressive progression and poor prognosis. In such cases, the malignant cells of MPNST usually have an epithelioid morphology. Here, the authors present a very rare case of spindle cell type MPNST arising in benign schwannoma. CASE: A 47-year-old woman had a history of wide marginal excision of right buttock spindle cell sarcoma previously...
May 5, 2017: Journal of Back and Musculoskeletal Rehabilitation
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