scholarly journals PALLIATIVE JAW-SPARING TREATMENT OF A NON-RESECTABLE CANINE ORAL FIBROSARCOMA USING COMBINATION OF ELECTROCHEMOTHERAPY WITH BLEOMYCIN AND IL-12 GENE ELECTROTRANSFER

2021 ◽  
Vol 58 (1) ◽  
Author(s):  
Darja Pavlin ◽  
Ana Nemec ◽  
Urša Lampreht Tratar ◽  
Maja Čemazar ◽  
Andreja Brožič ◽  
...  
Keyword(s):  
Complete Response ◽  
Needle Aspiration ◽  
Interleukin 12 ◽  
Initial Examination ◽  
Canine Tooth ◽  
Regional Lymph Nodes ◽  
Cd8 Cells ◽  
Normal Limits ◽  
Therapeutic Procedures ◽  
Clinically Significant

A 15-year- old male castrated English setter was presented for evaluation of a rapidly growing oral mass. Patient’s history was otherwise unremarkable, except of moderate proteinuria of 5 years duration. Clinical examination findings were within normal limits, except of an ulcerated located at the left mandibular canine tooth, which was histologically confirmed as a high grade infiltrative fibrosarcoma with high mitotic index (61/10 HPF) and multifocal necrotic areas. The client declined full staging, so only hematological and biochemistry examinations of blood were performed, which were without any clinically significant alterations. Furthermore a fine needle aspiration biopsy of regional lymph nodes was performed, which revealed reactive lymphadenopathy without signs of metastases. After declining other more invasive therapeutic procedures, the clients elected treatment with combination of electrochemotherapy and IL-12 electrogene therapy. Four consecutive treatment sessions were performed, resulting not only in complete response of the primary tumor, but also in regression of untreated distant metastasis, which was diagnosed approximately one month after the initial examination.  Furthermore, the percentage of circulating CD8+ cells was increased after each therapy session, indicating possible systemic induction of immune response by IL-12 gene therapy. This case shows that this type of therapy can represent an alternative type of both local and systemic treatment in selected tumor cases, where clients seek a less invasive nonsurgical treatment.Key words: dog; fibrosarcoma; electroporation; electrochemotherapy; electrogene therepy, interleukin-12 PALIATIVNO ZDRAVLJENJE NERESEKTABILNEGA FIBROSARKOMA SPODNJE ČELJUSTI PRI PSU S KOMBINACIJO ELEKTROKEMOTERAPIJE Z BLEOMICINOM IN GENSKEGA ELEKTROPRENOSA IL-12Izvleček: Petnajstleni kastrirani angleški seter je bil na našo kliniko sprejet z namenom pregleda hitro rastoče novotvorbe v ustni votlini. Pes ni imel pomembnejših sočasnih bolezni, razen zmerne proteinurije zadnjih pet let. Fizikalni pregled ni pokazal nikakršnih odstopanj z izjemo ulcerirane novotvorbe na področju levega mandibularnega grabilca. Histološka diagnoza novotvorbe je bila infiltrativni fibrosarkom visoke stopnje z visokim mitotičnim indeksom (61/10 v polju visoke povečave) in multifokalnimi nekrotičnimi področji. Skrbnik psa je zavrnil popolno določitev stadija bolezni, zato smo izvedli le osnovne hematološke in biokemijske preisakve, ki niso pokazale pomembnejših odstopanj. Izvedli smo tudi tankoligelno biopsijo regionalnih bezgavk, ki je pokazala reaktivno limfadenopatijo brez znakov prisotnosti zasevkov. Po predstavitvi vseh možnosti zdravljenja se je lastnik odločil za zdravljenje s kombinacijo elektrokemoterapije in genskega elektroprenosa IL-12. Izvedli smo štiri zaporedne cikluse kombinirane terapije, s katero smo dosegli ne le popolni odgovor primarnega tumorja, pač pa tudi regresijo nezdravljenih oddaljenih podkožnih metastaz, ki so se pojavile približno mesec dni po začetku terapije. Poleg tega smo po vsaki terapiji ugotovili povečan delež cirkulirajočih CD8+ celic, kar lahko nakazuje na to, da je genska terapija z IL-12 sprožila sistemski imunski odziv. Predstavljeni primer kaže, da lahko kombinacija elektrokemoterapije in genskega elektroprenosa IL-12 predstavlja alternativno obliko tako lokalnega kot sistemskega zdravljenja določenih novotvorb, zlasti v primerih, ko skrbnik živali želi manj invazivne terapevtske postopke.Ključne besede: pes; fibrosarkom; elektroporacija; elektrokemoterapija, genski eletroprenos; interlevkin-12

scholarly journals Algorithm for the Diagnosis and Treatment of Acute Biliary Pancreatitis

2005 ◽  
Vol 94 (2) ◽  
pp. 124-129 ◽  
Author(s):  
N. Alexakis ◽  
J. P. Neoptolemos
Keyword(s):  
Endoscopic Sphincterotomy ◽  
Severe Disease ◽  
Developed Countries ◽  
Needle Aspiration ◽  
Evidence Base ◽  
Infected Necrosis ◽  
Mild Disease ◽  
Long Term Follow Up ◽  
Clinically Significant ◽  
High Level

Gallstones are the commonest cause of acute pancreatitis in developed countries. There is now a considerable evidence base consolidated by a series of systematic reviews, metaanalyses and guidelines that has established a clear algorithm for diagnosis and management. In the majority of patients the combination of ultrasonography and serum alanine transaminase <60 iu/l >48 hours of symptoms will identify gallstones as the cause. The simplest method of severity assessment is a high level of serum C-reactive protein (> 150 mg/l up to 72 hours after symptoms). In mild disease, all fit patients must undergo laparoscopic cholecystectomy with intraoperative cholangiography or if not fit for surgery then endoscopic sphincterotomy during the same admission to prevent further attacks. All patients with severe disease should undergo endoscopic sphincterotomy in less than 72 hours. Patients with >30% necrosis should undergo fine needle aspiration for bacteriology. Necrosectomy is indicated for infected necrosis or sterile necrosis if there are persisting clinically significant symptoms. There is increasing evidence for the use of minimally invasive pancreatic necrosectomy. Enteral nutrition should be instituted whenever possible but antibiotics should be reserved for patients with proven sepsis. The presence of fungal infection requires active anti-fungal therapy. Patients with severe disease should undergo cholecystectomy at a later stage. Patients who have undergone necrosectomy require long-term follow-up because of delayed complications.

scholarly journals Different pathologic responses to neoadjuvant anti-PD-1 in primary squamous lung cancer and regional lymph nodes

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Yun Ling ◽  
Ning Li ◽  
Lin Li ◽  
Changyuan Guo ◽  
Jiacong Wei ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Regional Lymph Nodes ◽  
Primary Tumors ◽  
Neoadjuvant Immunotherapy ◽  
Squamous Lung Cancer ◽  
Nsclc Patients ◽  
Residual Viable Tumor

AbstractNeoadjuvant immunotherapy provides a unique opportunity for understanding therapeutic responses. We analyzed pathologic responses in surgical specimens obtained from 31 squamous non-small cell lung cancer (NSCLC) patients receiving neoadjuvant anti-PD-1 treatment. Fifteen (48.4%) patients achieved pathologic complete response (pCR) or major pathologic response (MPR). Among them, seven (46.7%) were assessed as radiological partial response and eight (53.3%) as stable disease. Among 20 patients with pathologically identified tumor beds in lymph nodes (LNs), 10 and six patients achieved pCR/MPR in primary tumors and paired LNs, respectively. pCR was achieved in 6/19 N1 nodes and 1/7 N2 nodes. Residual viable tumor (RVT) cells in 8/9 MPR specimens had 100% immune-activated phenotype, while a median of 80% of RVT cells in pathologic nonresponse specimens presented immune-excluded/desert phenotype. These findings demonstrated that assessment of pathologic responses in both primary tumor and LNs may be important as a surrogate for assessing neoadjuvant immunotherapeutic efficacy.

Intraconal Metastasis Leading to the Diagnosis of Hepatocellular Carcinoma

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S70-S71
Author(s):  
Irappa Madabhavi ◽  
Vinay Sakaleshpura Mallikarjuna ◽  
K S Sandeep ◽  
Malay Sarkar ◽  
Mansi Shah ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Ct Scan ◽  
Hepatitis B Surface Antigen ◽  
Needle Aspiration ◽  
Lateral Part ◽  
Orbital Metastasis ◽  
Regional Lymph Nodes ◽  
Clinical Indicators ◽  
Orbital Mass ◽  
Eosinophilic Cytoplasm

Abstract Hepatocellular carcinoma (HCC) is the most common malignant cancer of the liver, with intrahepatic and extrahepatic metastasis accounting for 50% to 75% of HCC cases. Lung and regional lymph nodes are the most common sites of metastasis; however, bone, skin, and adrenal glands are rare sites. Orbital metastasis and intracranial invasion are extremely rare and believed to occur in 2% to 3% of patients with systemic cancer. Here, we present a case report of a 72-year-old man evaluated for progressive painful proptosis of the left eye with weight loss, loss of appetite, and generalized weakness of 3 months duration. Physical examination showed a 5.5 × 3.5-cm, firm, mildly tender mass in the upper and lateral part of the left eye with proptosis and hepatomegaly with no ascites. Laboratory investigations were within normal limits except for positive hepatitis B surface antigen and HBV-DNA. CT scan of the head and neck revealed a 5.7 × 4.7-cm heterogeneously enhancing irregular extraconal mass seen in superolateral aspect of the left orbit. Abdominal CT scan showed hepatomegaly with multiple heterogeneous enhancing lesions in the liver. Fine-needle aspiration from the orbital and liver lesions showed individually scattered clusters and sheets of round to polyhedral cells with enlarged, hyperchromatic nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm. Immunohistochemistry showed tumor cells strongly positive for hepatocyte paraffin 1 (HepPar 1) and CD10 but negative for TTF-1, CEA, ALK-1, LCA, vimentin, S-100, and chromogranin, consistent with the diagnosis of HCC. Patient was started on chemotherapy and showed significant improvement with decrease in the size of the liver and orbital mass. Based on the present case and review of literature published since 2009, the current study recommends that metastasis must be considered when diagnosing retrobulbar head lesions in patients with HCC, regardless of contradictory imaging findings and other clinical indicators.

Docetaxel: an active drug for squamous cell carcinoma of the head and neck.

1996 ◽  
Vol 14 (5) ◽  
pp. 1672-1678 ◽  
Author(s):  
A I Dreyfuss ◽  
J R Clark ◽  
C M Norris ◽  
R M Rossi ◽  
J W Lucarini ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Complete Response ◽  
Rapid Onset ◽  
Outpatient Basis ◽  
Hypersensitivity Reactions ◽  
Major Activity ◽  
Clinically Significant

PURPOSE We conducted a phase II study designed to evaluate the activity, safety, and tolerability of docetaxel (Taxotere: Rhône-Poulenc Rorer Pharmaceuticals Inc, Collegeville, PA) in patients with advanced, incurable, or recurrent squamous cell carcinoma of the head and neck (SCCHN) who had not received prior palliative chemotherapy. PATIENTS AND METHODS Thirty-one patients with measurable, locoregional, or metastatic SCCHN were treated with docetaxel, administered at a dose of 100 mg/m2 as a 1-hour intravenous (i.v.) infusion once every 21 days on an outpatient basis. All patients were premedicated with dexamethasone, diphenhydramine, and cimetidine. Prophylactic administration of growth factors or antiemetics was not permitted. RESULTS Thirty-one patients were treated. Twenty-nine patients were assessable for response and 30 for toxicity. Four of 31 patients (13%) achieved complete response (CR), nine (29%) achieved partial response had stable disease (SD) and seven (23%) experienced progression of disease (PD). The major response rate was 42% (95% confidence interval [CI], 24% to 60%). The median duration of responses was 5 months (range, 2 to 14). The principal toxicity was leukopenia, which occurred with rapid onset and brief duration. Sixteen patients (53%) experienced nadir fever, and 13 required dose reduction. Hypersensitivity reactions occurred in four patients. Grade 3 peripheral neuropathy occurred in two patients; grade 2 or 3 fatigue occurred in six (20%) and 10 (33%), respectively. Minimal edema (grade 1) occurred in five patients (17%). Clinically significant mucositis, diarrhea, or dermatitis were not observed. CONCLUSION Docetaxel has major activity against SCCHN. It appears to be well tolerated in this group of patients and can be safely administered on an outpatient basis. Premedication with dexamethasone, cimetidine, and diphenhydramine is associated with a reduced incidence of significant edema, hypersensitivity reactions, and dermatologic toxicities.

scholarly journals Sistrunk Procedure on Malignant Thyroglossal Duct Cyst

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Diani Kartini ◽  
Sonar S. Panigoro ◽  
Agnes S. Harahap
Keyword(s):  
Rare Event ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Cystic Mass ◽  
Thyroglossal Duct Cyst ◽  
Duct Cyst ◽  
Microscopic Appearance ◽  
Thyroglossal Duct ◽  
Normal Limits ◽  
Sistrunk Procedure

A thyroglossal duct cyst is a lesion that occurs as a result from failure of the thyroglossal duct to obliterate during fetal development. Malignant progression is a rare event that might occur in less than 1% of all cases. Because of its rarity, there are conflicting opinions regarding the management of the case. In the present study, a 46-year-old male presented with a painless neck mass that had increased in size over the last 6 months. There was no difficulty in swallowing and breathing, change in voice, significant weight loss, or any signs of hyperthyroidism. Laboratory workup showed that results were within normal limits. Thyroid gland ultrasonography and cervical contrast CT scan revealed a complex cystic mass that pointed towards a thyroglossal duct cyst. We performed Sistrunk procedure. Postoperative pathology examination revealed microscopic appearance of the thyroglossal duct cyst with a classic follicular variant of papillary thyroid carcinoma. Our latest follow-up showed no signs of tumor recurrence or any complications following surgery on locoregional status. As a fine needle aspiration biopsy cannot ensure a precise result in all of cases, it is essential to perform a solid physical examination and thorough supporting examination in deciding the precise management for the patient.

scholarly journals A Critical Role for Cd40–Cd40 Ligand Interactions in Amplification of the Mucosal Cd8 T Cell Response

1999 ◽  
Vol 190 (9) ◽  
pp. 1275-1284 ◽  
Author(s):  
Leo Lefrançois ◽  
Sara Olson ◽  
David Masopust
Keyword(s):  
T Cells ◽  
T Cell ◽  
T Cell Activation ◽  
Cd8 T Cells ◽  
Adoptive Transfer ◽  
Cell Activation ◽  
Cd8 T Cell ◽  
Cd40 Ligand ◽  
Interleukin 12 ◽  
Cd8 Cells

The role of CD40 ligand (CD40L) in CD8 T cell activation was assessed by tracking antigen-specific T cells in vivo using both adoptive transfer of T cell receptor transgenic T cells and major histocompatibility complex (MHC) class I tetramers. Soluble antigen immunization induced entry of CD8 cells into the intestinal mucosa and cytotoxic T lymphocyte (CTL) differentiation, whereas CD8 cells in secondary lymphoid tissue proliferated but were not cytolytic. Immunization concurrent with CD40L blockade or in the absence of CD40 demonstrated that accumulation of CD8 T cells in the mucosa was CD40L dependent. Furthermore, activation was mediated through CD40L expressed by the CD8 cells, since inhibition by anti-CD40L monoclonal antibodies occurred after adoptive transfer to CD40L-deficient mice. However, mucosal CD8 T cells in normal and CD40−/− mice were equivalent killers, indicating that CD40L was not required for CTL differentiation. Appearance of virus-specific mucosal, but not splenic, CD8 cells also relied heavily on CD40–CD40L interactions. The mucosal CTL response of transferred CD8 T cells was MHC class II and interleukin 12 independent. The results established a novel pathway of direct CD40L-mediated CD8 T cell activation.

Electrochemotherapy with intra-tumoral cisplatin for the treatment of fibrosarcoma in a horse

2018 ◽  
Author(s):  
M. Bharathidasan ◽  
B. Justin William ◽  
Ravi Sundar George Sundar George ◽  
A. Arunprasad ◽  
R. Sivasankar
Keyword(s):  
Complete Response ◽  
Tumour Volume ◽  
Needle Aspiration ◽  
Medial Aspect ◽  
History Of ◽  
Subcutaneous Tissues ◽  
Needle Aspiration Cytology ◽  
One Year ◽  
The Right

A two years old Kathiawar stallion was reported with the history of two, pedunculated hard mass medially on the thigh and hock of the right hind limb, progressively increasing for the past two months. Fine needle aspiration cytology revealed fibrosarcoma.The tumour on the medial aspect of the thigh was injected with cisplatin intra-tumorally at a dose rate of 0.3 mg/cm3 of tumour volume and was exposed to ECT. The tumour on the medial aspect of the hock was excised incompletely to preserve skin and subcutaneous tissues around the tumour for wound opposition and treated with intra-tumoral injection of cisplatin followed by ECT. Following electrochemotherapy complete response was noticed onthe 3rd and 4th week for the tumours on the thigh and hock respectively. No recurrence was noticed during the follow-up period of one year revealing ETC with cisplatin as a single treatment and also in combination with surgery is effective for the treatment of fibrosarcoma in equines.

Chemoradiotherapy for highly advanced gastric cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 121-121
Author(s):  
Mai Tsutsui ◽  
Tsunehiro Takahashi ◽  
Yoshiro Saikawa ◽  
Hirofumi Kawakubo ◽  
Norihito Wada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Radiation Therapy ◽  
Lymph Nodes ◽  
Advanced Gastric Cancer ◽  
Multidisciplinary Treatment ◽  
Multimodality Treatment ◽  
Complete Response ◽  
Technological Advancement ◽  
Regional Lymph Nodes ◽  
Grade 3

121 Background: Although the prognosis of early gastric cancer is favorable, the treatment for advanced cases still have difficulty in achieving satisfactory results. Thus, more effective multimodality treatment should be established. Chemoradiotherapy has become a standard treatment for gastric cancer especially as an adjuvant therapy while radiotherapy has been expected as one of the modalities against highly advanced gastric cancer. Methods: Patients with advanced gastric cancer who were treated with chemotherapy of S-1 and cisplatin plus radiation were analyzed retrospectively. Concurrent radiation therapy (5 days/week) at 2 Gy/day was started with chemotherapy and repeated daily on days 1–5, 8–12, 15–19 and 22–26. Irradiation was planned using a computed tomography (CT) simulator for two rectangular portals with a pair of 45-degree wedge filters and was targeted at the primary tumor and surrounding lesions, including lymph nodes. Results: A total 109 patients were treated with chemoradiotherapy between 2002 and 2013 at our institute. The median age was 64 years. Histological type included 45 differentiated and undifferentiated 64 subtypes. The TNM stage before the treatment was diagnosed as IIIA: 11; IIIB: 10; IIIC: 14; IV: 74. Of the 98 evaluable patients, 69 patients had partial responses while no patients had a complete response, resulting in an overall response rate of 70%. Progressive disease (PD) occurred in 2 patients (4%). The most frequent adverse events more than grade 3 were hematologic toxicities, including leukocytopenia (47%), neutropenia (25%), and thrombocytopenia (24%). Non-hematologic toxicities such as general fatigue, renal-related events, and gastrointestinal toxicities were manageable with no treatment-related death. The median survival time was 537 days. Conclusions: While there were disadvantages of radiotherapy including the difficulty of confirming the area of irradiation due to peristaltic movement, risk of perforation and ulceration, recent technological advancement of radiation therapy has enabled pinpoint accuracy in treatment of primary gastric lesions and regional lymph nodes. There has been much anticipation that chemoradiotherapy will be a part of multidisciplinary treatment for advanced cancer.

scholarly journals Diagnosis and surgical management of acanthomatous ameloblastoma in a 5-month-old female Boerboel puppy

2021 ◽  
Vol 18 (4) ◽  
pp. 239-244
Author(s):  
I.O. Oyenekan ◽  
M.O. Ilugbo ◽  
O.O. Adebayo ◽  
A.A. Adebiyi ◽  
S.A. Koleosho ◽  
...  
Keyword(s):  
Fine Needle Aspiration Biopsy ◽  
Operative Management ◽  
Needle Aspiration ◽  
Fine Needle Aspirate ◽  
Canine Tooth ◽  
Maxillary Canine ◽  
Fine Needle ◽  
Odontogenic Epithelium ◽  
Skull Radiography ◽  
The Right

A five-month-old female Boerboel puppy presented with a rapidly expanding fibrous growth around the canine tooth of the right maxilla was diagnosed as having acanthomatous ameloblastoma based on findings from skull radiography, cytology of fine needle aspiration, biopsy and histopathology of resected growth. Lateral radiograph of the skull revealed moderate osteolysis of the maxilla with presence ofun-erupted maxillary canine teeth. Cytology of fine needle aspirate from the growth showed clusters of epithelial cells that were  hyperchromatic and showing palisade arrangement. The mass was surgically resected using diathermy instrument following general anaesthesia using combination of intramuscular injection of xylazine (0.5mg/kg), and intravenous injection of propofol (4mg/kg). Post-operative management included Ibuprofen suspension (100mg) administered for 3-days, intravenous vincristine (0.5mg/m2 ) once weekly and oral cyclophosphamide (50mg) was administered twice weekly for six weeks. Histopathology of the growth showed odontogenic epithelium embedded in pulp ectomesenchyme. Features of odontogenic epithelium include palisading epithelium with anti-basilar nuclei and centrally located cells having features of stellate reticulum. This is probably the first reported case of acanthomatous ameloblastoma in a Boerboel puppy that was successfully managed. Keywords: Acanthomatous, Ameloblastoma, Boerboel-puppy, Chemotherapy, Odontoid

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