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radiation therapy hemorrhage

Sarah L Sheu
Tranexamic acid is a procoagulant agent that is approved by the US Food and Drug Administration for treatment of menorrhagia and to prevent hemorrhage in patients with hemophilia undergoing tooth extractions. Through its inhibitory effects on the plasminogen activation pathway, tranexamic acid also mitigates the UV radiation-induced pigmentation response. Systemic tranexamic acid has consistently been reported as an effective treatment of melasma, though its broad use may be limited by the risk for thromboembolism...
February 2018: Cutis; Cutaneous Medicine for the Practitioner
Tomas Vedin, Sebastian Svensson, Marcus Edelhamre, Mathias Karlsson, Mikael Bergenheim, Per-Anders Larsson
PURPOSE: Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of adults with head trauma over a 1-year period to identify clinical features predicting intracranial hemorrhage. METHODS: Medical record data have been collected retrospectively in adult patients with traumatic brain injury...
March 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
David Reichstein, Kayla Karan
PURPOSE OF REVIEW: Plaque brachytherapy remains the dominant globe-sparing therapy of uveal melanoma. This report highlights recent advances, which have expanded plaque brachytherapy's uses as well as improved the surgical technique. RECENT FINDINGS: Plaque brachytherapy is effective for tumors that may previously have demanded enucleation. Plaque brachytherapy can be used to control large melanomas as well as melanomas touching the optic nerve. Improvements in planning and design have made plaque therapy simpler for the surgical operator and may reduce collateral radiation damage to normal ocular structures...
March 13, 2018: Current Opinion in Ophthalmology
José Pedro Lavrador, Edson Oliveira, Joaquim Cruz Teixeira, José Pedro Lopes, José Pimentel, Manuel Herculano Carvalho
We report a 69-year-old patient with left paresthesia and hemiparesis. Magnetic resonance imaging revealed a right frontoparietal cystic tumor. A subtotal surgical resection was performed, and an Ommaya reservoir was left in place. The pathological diagnosis was supratentorial extraventricular anaplastic ependymoma. Radiation therapy was administered, and Ommaya reservoir drainages were performed. Four months after, her clinical status deteriorated after a reservoir drainage and image revealed an acute hemorrhage...
January 2018: Asian Journal of Neurosurgery
P Brandicourt, L Bonnet, Y Béjot, C Drouet, T Moulin, L Thines
INTRODUCTION: Moya-Moya angiopathy is a neurovascular disease that predisposes to ischemic or hemorrhagic strokes. It is generated by a steno-occlusion of the terminal portion of the internal carotid arteries, which induces the development of abnormal neovessels in the deep regions of the brain. Some pathologies such as sickle cell disease, Down syndrome or Graves' disease may be associated with Moya-Moya angiopathy. These syndromic forms harbor several differences compared with idiopathic Moya-Moya disease...
February 20, 2018: Neuro-Chirurgie
Harumi Sawada, Akihiro Mori, Peter Lee, Shiho Sugihara, Hitomi Oda, Toshinori Sako
The purpose of this study was to determine the therapeutic and/or adverse effects of radiation therapy (RT) against pituitary tumors in dogs with pituitary-dependent hypercortisolism, as monitored by frequent post-RT detailed MRI examinations, clinical signs, and changes in hormone concentrations. Nine dogs with an adrenocorticotropic hormone (ACTH)-secreting pituitary mass diagnosed by magnetic resonance imaging (MRI) underwent RT for 4weeks (total of 48Gy in 4-Gy fractions). Pituitary height/brain area (P/B) value, clinical signs, basal plasma ACTH concentrations, serum cortisol concentrations (pre- and post-ACTH stimulation test) and adverse effects of RT were evaluated before and post-RT...
January 10, 2018: Research in Veterinary Science
Gábor Nagy, Brandon A McCutcheon, Caterina Giannini, Michael J Link, Bruce E Pollock
BACKGROUND: Stereotactic radiosurgery (SRS) is a commonly performed procedure for patients with intracranial meningiomas. OBJECTIVE: To describe the clinical features of patients with radiation-induced cavernous malformations (RICM) after single-fraction meningioma SRS. METHODS: Retrospective study of patients having single-fraction SRS for intracranial meningioma at our center from 1990 through 2009, and 1 patient who had single-fraction SRS elsewhere...
December 21, 2017: Operative Neurosurgery (Hagerstown, Md.)
Marcelo D Vilela, William T Longstreth, Hugo As Pedrosa, Gabriel Ob Gil, Juliano M Duarte, Marco Antonio D Filho
BACKGROUND: Trastuzumab emtansine, an antibody-drug conjugate commonly abbreviated as T-DM1, is accepted as an effective therapy for trastuzumab-resistant metastatic HER2-positive breast cancer. T-DM1 significantly increases progression-free and overall survival when compared to lapatinib plus capecitabine in patients with HER2-positive breast cancer previously treated with trastuzumab and a taxane. Among the common side effects related to T-DM1, thrombocytopenia and mucosal hemorrhage are seen, although they are infrequently judged to be clinically significant...
December 20, 2017: World Neurosurgery
Ashley Case, Kristine Burgess
OBJECTIVE To evaluate the safety and efficacy of intralesional triamcinolone administration, as a sole or adjuvant treatment, in dogs with mast cell tumors. DESIGN Retrospective case series ANIMALS 23 dogs with mast cell tumors. PROCEDURES Medical records of dogs treated for a confirmed diagnosis of a mast cell tumor between 2005 and 2011 were reviewed. Patients with a confirmed diagnosis and measurable disease (tumor longest dimension ≥ 0.5 cm) that had received ≥ 1 intralesional treatment with triamcinolone, regardless of prior, concurrent, or adjuvant treatments, were eligible for inclusion...
January 1, 2018: Journal of the American Veterinary Medical Association
Kai Quan, Xuqun Tang, Jianping Song, Xiancheng Chen, Yanlong Tian, Peixi Liu, Yuan Shi, Zixiao Yang, Yinjun Liu, Feng Zhou, Li Pan, Wei Zhu
OBJECTIVE: The aim of this study was to investigate delayed complications in patients with brain arteriovenous malformation (BAVM) after Gamma Knife stereotactic radiosurgery and to present the salvage therapy experiences of patients with BAVM with radiation-induced changes (RICs) or intracranial hemorrhage (ICH). METHODS: This cohort consisted of 44 patients with BAVM who underwent failed GKRS between 2000 and 2015. These patients were further divided into an RIC group (23 patients) and an ICH group (21 patients) based on their post-GKRS complications...
February 2018: World Neurosurgery
Kazuhiko Morikawa, Hirokazu Ashida, Yosuke Nozawa, Kenji Motohashi, Takao Igarashi, Hiroya Ojiri, Yuji Kanaoka, Takao Ohki
Primary aortoduodenal fistula (ADF) is a direct communication between the abdominal aorta and the gastrointestinal tract without any previous vascular intervention and represents a rare but critical cause of repeated and massive gastrointestinal bleeding. Primary ADF often occurs as a result of atherosclerotic aneurysm and infection, but ADF involving a normal-size aorta is rare; furthermore, ADF related to radiation therapy is extremely rare. We present the case of a 56-year-old man with a history of bowel obstruction due to radiation enteritis who was admitted with severe hematemesis and hemorrhagic shock...
2017: Case Reports in Radiology
Stephanie L Skala, Alexandra C Hristov, Johann E Gudjonsson, May P Chan
Clinical diagnosis of lymphomatoid granulomatosis (LYG) often is difficult, especially in patients with multiple comorbidities. We present a 60-year-old woman with worsening fatigue, night sweats, unintentional weight loss, and dyspnea of 2 weeks' duration. Her medical history was remarkable for recent radiation therapy for recurrent breast cancer and antisynthetase syndrome complicated by interstitial lung disease and controlled with azathioprine. Computed tomography showed ground-glass opacities and nodular infiltrates in all lung lobes, raising concern for radiation pneumonitis and drug toxicity...
October 2017: Cutis; Cutaneous Medicine for the Practitioner
Derek Yecies, Paul Graham Fisher, Samuel Cheshier, Michael Edwards, Gerald Grant
OBJECTIVE Primarily metastatic juvenile pilocytic astrocytoma (JPA) is rare, likely representing 2%-3% of all cases of JPA. Due to the rarity of primarily metastatic JPA, there is currently no standard treatment paradigm and the long-term outcomes are not fully known. The goal of this case series was to add to the current understanding of this disease process. METHODS The authors searched a comprehensive database of pediatric patients with brain and spinal cord tumors treated at Lucile Packard Children's Hospital from 1997 to 2016 and identified 5 patients with primarily metastatic JPA...
November 10, 2017: Journal of Neurosurgery. Pediatrics
Flavio Requejo, Juan Marelli, Agustin Ruiz Johnson, Claudia Sampor, Guillermo Chantada
Background Superselective ophthalmic artery chemotherapy (SOAC) is a proven therapy for the treatment of retinoblastomas. We describe the technique, results and complications of SOAC performed in our hospital. Objective The aim of this article is to demonstrate that a seemingly complex technique can be carried out with a low morbidity rate. Methods A retrospective analysis of patients receiving SOAC in our department from November 2014 to April 2017 was performed. Data collected were age, gender, number of procedures, arteries approached, bilaterality of treatment, and complications...
January 1, 2017: Interventional Neuroradiology
Rafi Kabarriti, Thomas J Quinn, Michelle R Ewart, Keyur J Mehta, Craig Lomita, David S Geller, Shalom Kalnicki, Jana L Fox
Myoepithelial tumors of the soft tissue are a rare tumor displaying myoepithelial elements and lacking obvious ductal differentiation. The rarity of these precludes any evidence-based consensus regarding optimal management. Nevertheless, the current approach to these lesions begins with amputation or complete excision. The efficacy of neoadjuvant or adjuvant radiation therapy or chemotherapy has not been established. Here, we present the first report to the authors' knowledge of neoadjuvant radiation therapy for the treatment of this rare soft tissue neoplasm and review the management and outcomes of published cases of myoepithelial carcinoma...
October 12, 2017: International Journal of Cancer. Journal International du Cancer
Grant Riesberg, Girish Bathla, Sarika Gupta, Pankaj Watal, Toshio Moritani
Gangliogliomas are rare, typically benign low grade tumors which usually occur in the supratentorial compartment, more commonly in the pediatric age group. Malignant transformation of a low grade ganglioglioma in the absence of prior radiation therapy is exceptionally rare with only 17 such cases previously reported. The author present an additional case of malignant transformation of recurrent ganglioglioma. Unlike the prior cases however, the recurrent tumor in our case showed prominent intratumoral hemorrhage and widespread leptomeningeal spread...
September 20, 2017: Clinical Imaging
Danielle N Margalit, Jonathan D Schoenfeld, Bhupendra Rawal, Robert I Haddad, Paul J Catalano, Laura A Goguen, Nicole G Chau, Guilherme Rabinowits, Jochen H Lorch, Donald J Annino, Roy B Tishler
OBJECTIVES: To characterize specific serious toxicities of reRT with intensity modulated radiation therapy (IMRT) for squamous cell carcinoma of the head and neck (SCCHN) and identify treatment-related predictors of toxicity for patient counseling and decision-making. MATERIALS/METHODS: 75 consecutive patients with recurrent or 2nd primary SCCHN received reRT from 8/2004-02/2013. All patients had prior definitive or postoperative RT. Objective endpoints of "serious toxicity" were defined as: hospitalization during reRT, tracheotomy after reRT, hemorrhage, soft tissue complication requiring operative intervention, or other CTCAE grade ≥4 toxicity...
October 2017: Oral Oncology
Keiichi Jingu, Yuzuru Niibe, Hideomi Yamashita, Kuniaki Katsui, Toshihiko Matsumoto, Tomohiro Nishina, Atsuro Terahara
BACKGROUND: Neoadjuvant chemoradiotherapy following surgery has recently become a standard therapy. The purpose of the present study was to determine the effectiveness and toxicity of re-irradiation for oligo-recurrence in lymph nodes from esophageal cancer treated by definitive radiotherapy or by surgery with additional radiotherapy. METHODS: We reviewed retrospectively 248 patients treated with (chemo)radiotherapy for oligo-recurrence in lymph nodes from esophageal cancer in five Japanese high-volume centers between 2000 and 2015...
September 5, 2017: Radiation Oncology
Stephen F Kralik, Gordon A Watson, Chie-Schin Shih, Chang Y Ho, Whitney Finke, Jeffrey Buchsbaum
PURPOSE: The purpose of this research was to evaluate the incidence, time to development, imaging patterns, risk factors, and clinical significance of large vessel cerebral vasculopathy in pediatric patients with brain tumors treated with proton radiation therapy. METHODS AND MATERIALS: A retrospective study was performed on 75 consecutive pediatric patients with primary brain tumors treated with proton radiation therapy. Radiation-induced large vessel cerebral vasculopathy (RLVCV) was defined as intracranial large vessel arterial stenosis or occlusion confirmed on magnetic resonance angiography, computed tomographic angiography, catheter angiography, or a combination of these within an anatomic region with previous exposure to proton beam therapy and not present before radiation therapy...
November 15, 2017: International Journal of Radiation Oncology, Biology, Physics
Zachary Wilseck, Luis Savastano, Neeraj Chaudhary, Aditya S Pandey, Julius Griauzde, Sumanna Sankaran, D Andrew Wilkinson, Joseph J Gemmete
Carotid blowout syndrome (CBS) is a known devastating complication of head and neck surgery. The risk of developing CBS increases in the setting of radiation therapy, wound breakdown, or tumor recurrence. Traditionally, the treatment of choice for CBS is surgical ligation of the bleeding artery; however, recently, endovascular occlusion has become a more common option. If a pseudoaneurysm is present, treatment consists of trapping with endovascular coils or occlusion with a liquid embolic agent. Delayed migration of embolization coils into the airway causing acute respiratory distress is a rare occurrence...
August 29, 2017: BMJ Case Reports
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