“Study Design. Retrospective
analysis of breast cancer patients with metastatic epidural spinal cord compression (MESCC) undergoing surgery and radiation therapy.
Objective. To assess feasibility and clinical outcome of multidisciplinary approach in breast cancer patients with MESCC.
Summary of Background Data. Studies so far published in the setting of surgery and/or radiotherapy selleck chemicals in the management of MESCC usually included many malignancies, without considering the different primary histology. However, when looking at prognostic variables of this therapy, histological type comes out as a major determinant of outcome.
Methods. Twenty-three patients with symptomatic MESCC from breast cancer treated between January 2004 and April 2009 were included in this analysis. Selleck Proteasome inhibitor Twenty-six surgical procedures followed by radiotherapy were performed. Clinical outcome and local recurrence was evaluated by modified visual analog scale for pain, Frankel scale for neurologic deficit, and magnetic resonance imaging or computed tomography scans. Twenty-three cases (88.4%) had back pain before treatment with a visual analog scale score 6 or greater; neurologic deficit (FS A-D) was present
in 19 cases (65.5%).
Results. Complete remission of pain, lasting until death or progression of disease in another skeletal site, was obtained in 25/26 cases (96.1%). All patients had complete recovery of neurologic deficit. No major morbidity occurred. No patients had recurrence in the site of treatment. Median survival was 36 months (range, 3-60) and overall survival at one, three, and five years was 70%, 42%, and 34%, respectively.
Conclusion. We provided evidence of surgery and radiotherapy to be feasible with limited morbidity. see more Clinical outcome has been highly satisfactory in terms of pain and local disease control. The discussion of each case within a multidisciplinary team is of central importance in defining the most appropriate therapeutic approach.”
“Idiopathic membranoproliferative glomerulonephritis
(MPGN) is a rare cause of renal failure with a cumulative incidence of 0.3% of all ESRD and 4% of all primary glomerulonephritis for types I and II. Membranoproliferative glomerulonephritis type III is more uncommon and idiopathic de novo MPGN III in a renal transplant patient has not been reported. We present the case of a 57-year old white female patient with a diagnosis of lithium toxicity as cause of end stage renal disease (ESRD) who developed MPGN III in her allograft 6 years after a renal transplant. Despite treatment, she progressed to ESRD within four and a half years from the time of diagnosis.”
“We report a 68-year-old woman who experienced visual hallucinations diagnosed as peduncular hallucinosis (PH) following microvascular decompression for trigeminal neuralgia. Postoperative MRI showed only ischemic oedema of the left cerebellar hemisphere due to retraction.