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Interferon-related mental deterioration and behavioral changes in patients with renal cell carcinoma
《European journal of cancer & clinical oncology》1990,26(5):596-600
Five out of 38 patients (13%) with metastatic renal cell carcinoma had mental deterioration 3 weeks to 13 months after the start of treatment with recombinant interferon alpha-C. Metastatic spread to the brain, paraneoplastic effect of the tumor on the central nervous system and other causes of dementia were excluded. Computed tomography of the brain in these patients was normal and the width of the cerebral sulci and ventricles did not correlate with the severity of dementia. Specific patterns of atrophy were not seen. General deterioration, assessed by the change in Karnofsky performance status, was associated with dementia. The dementia may have been caused by a neurotoxic effect of interferon. 相似文献
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Bilen MA Waguespack SG Tannir NM Pravinkumar SE Tamboli P Tu SM 《Clinical genitourinary cancer》2008,6(2):128-130
We describe the case of a patient who presented with a kidney lesion, lymphadenopathy, and bone metastasis. He developed a tetrad of high fever, encephalopathy, labile blood pressure, and multiple organ system failure. Initially, he was diagnosed with metastatic renal cell carcinoma (RCC). His fevers and encephalopathy were compatible with a putative paraneoplastic syndrome. Eventually, he was found to have malignant pheochromocytoma. To our knowledge, this is the first reported case of a malignant pheochromocytoma with multisystem crisis. Because of its atypical presentation and unusual findings, a high index of suspicion is necessary for the timely diagnosis of this clinical entity. Prompt diagnosis and appropriate treatments could improve the performance status and quality of life of such patients. 相似文献
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Silvestris N D'Elia F Tarantino G Lucarelli A 《Journal of experimental & clinical cancer research : CR》2000,19(3):399-400
Merkel cell carcinoma (MCC) is an aggressive neuroendocrine skin cancer which seems to be common in transplant recipients. We describe the case of a renal transplant patient who developed a MCC on the right glutaeus eight years after transplantation. 相似文献
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Background
Ciliated hepatic foregut cyst is a rare condition almost always found incidentally on a computerized tomography scan or at autopsy. Rarely, portal vein compression can be a presenting finding. The cysts are usually unilocular and occur with greater frequency in males. There is a predilection for the left lobe. The cysts average 3 cm in size. 相似文献7.
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Rashid MH Welsh CT Bissada NK Chaudhary UB 《American journal of clinical oncology》2005,28(1):107-108
Sarcomatoid renal cell carcinoma (SRCC) is a heterogeneous disease with generally unreliable response to various therapies in clinical studies. We illustrate a case report in which a woman with metastatic SRCC had a complete and durable response to adriamycin and ifosfamide chemotherapy. We find this to be incongruous with expectations from some recently published data. It underscores the fact that the biology of SRCC needs to be studied in more detail for further subcataloging of the disease into diverse prognostic categories. 相似文献
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Wu J Langford LA Schellingerhout D Guha-Thakurta N Tummala S Weinberg JS Puduvalli VK 《Journal of neuro-oncology》2011,103(3):791-796
Malignant gliomas are aggressive malignancies which inevitably recur despite multimodality treatment. In a subset of patients
who are longer term survivors of this disease, progressive radiologic worsening can also occur from late effects of radiation
rather than recurrent tumor, a differential diagnosis that is commonly considered in this setting. However, other causes for
radiologic progression are not as well recognized and could potentially confound management leading to incorrect treatment
decisions. Progressive multifocal leukoencephalopathy (PML) is a rare infectious demyelinating disease of the central nervous
system seen primarily in immunocompromised patients, the early diagnosis and treatment of which remains a challenge. Here,
we report a case of a long term survivor with glioblastoma whose diagnostic and therapeutic management was confounded by the
development of PML. We review the radiological features and clinical course of this patient to highlight the dramatic neurological
course in the setting of a highly malignant tumor, and emphasize the unusual changes in diffusion weighted images, and the
need for clinical suspicion for early diagnosis of PML. 相似文献
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Keiko Shinsako Tomoyuki Mizuno Tomohiro Terada Jun Watanabe Tomomi Kamba Eijiro Nakamura Osamu Ogawa Ken-ichi Inui 《International journal of clinical oncology / Japan Society of Clinical Oncology》2010,15(5):512-514
Sorafenib (Nexavar®) has been approved for the treatment of advanced renal cell carcinoma (RCC) and hepatocellular carcinoma. There is little information on the dosage adjustment of sorafenib for patients with end-stage renal failure. Herein, we have examined the effect of hemodialysis on the pharmacokinetics of sorafenib and its major active metabolite, M-2, and assessed sorafenib-related toxicity throughout the therapy. The patient was a 54-year-old man who was diagnosed with advanced RCC. Pharmacokinetic analysis was carried out on days 9 and 183. The patient had stable disease on day 77 and showed progression on day 181. He has received about 6 months of continuous treatment with sorafenib 800 mg/day without any clinically relevant toxicity. The pharmacokinetic parameters of sorafenib such as C max and AUC0–12 on day 183 were in the range of the reference values reported in patients with normal renal function. Our results suggest that sorafenib administered at a dose of 400 mg twice per day was well tolerated, at least for 6 months, for a patient undergoing hemodialysis. 相似文献
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Webster WS Lohse CM Thompson RH Dong H Frigola X Dicks DL Sengupta S Frank I Leibovich BC Blute ML Cheville JC Kwon ED 《Cancer》2006,107(1):46-53
BACKGROUND: The impact of mononuclear cell infiltration on renal cell carcinoma (RCC) biology has been controversial, previously reported to be associated with either a favorable or unfavorable prognosis. The objective of the current study was to evaluate associations between mononuclear cell infiltration in routinely prepared paraffin-embedded specimens with survival in patients with clear-cell RCC. METHODS: A total of 306 patients were identified treated with nephrectomy for clear-cell RCC between 1990 and 1994. A single urologic pathologist, blinded to patient outcome, reviewed the specimens and quantified the extent of mononuclear cell infiltration as absent, focal, moderate, or marked. Cancer-specific survival was estimated using the Kaplan-Meier method. Associations of mononuclear cell infiltration with death from RCC were assessed using Cox proportional hazards regression models. RESULTS: At last follow-up, 173 of the 306 patients studied had died, including 96 patients who died from RCC. Mononuclear cell infiltration was absent in 165 (54%), focal in 70 (23%), moderate in 53 (17%), and marked in 18 (6%). Univariately, patients with specimens that had mononuclear cell infiltration were over 2 times more likely to die from RCC compared with patients whose specimens exhibited no mononuclear cell infiltration (risk ratio, 2.63; P < .001). After adjusting for the Mayo Clinic SSIGN (stage, size, grade, and necrosis) score, patients with specimens that had mononuclear cell infiltration exhibited a significantly increased likelihood of dying from RCC compared with patients whose specimens had no mononuclear cell infiltration (risk ratio, 1.61; P = .028). CONCLUSIONS: Mononuclear cell infiltration is associated with death from RCC even after multivariate adjustment. Routine documentation of mononuclear cell infiltration is recommended during the pathologic assessment of RCC. 相似文献
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M Exner R Thalhammer-Scherrer S Kudlacek I Simonitsch U J?ger I Schwarzinger 《Leukemia & lymphoma》2001,42(1-2):239-241
We describe a patient who concomitantly presented with renal cell carcinoma (RCC) and hairy cell leukemia (HCL). Hairy cells formed atypical cell convolutes on bone marrow smears that might have been mistaken for tumor metastases. 相似文献
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Ismail Alrashdi Samantha Levine Joan Paterson Rohit Saxena Soonie R. Patel Sarita Depani Darren R. Hargrave Kathy Pritchard-Jones Shirley V. Hodgson 《Familial cancer》2010,9(2):239-243
Hereditary leiomyomatosis and renal cell cancer is a hereditary cancer syndrome in which affected individuals are at risk for cutaneous and uterine leiomyomas, and renal cancer. Previous reports have stressed the aggressiveness of the renal tumours, often with early metastasis, despite small primary tumour size. Almost all the previously reported patients were adults, and different studies showed variability in penetrance for the renal tumours. We report a patient in whom renal cancer was detected at the age of 11 years at his first routine screening imaging after he was found to carry a fumarate hydratase gene mutation (c.1189G > A) transmitted from his mother. This report serves to emphasize the need to improve guidelines for screening of at risk individuals, including the necessity for predictive genetic testing and early institution of tumour surveillance in childhood. 相似文献