• The Korean Journal of Pain
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• v.2 no.1
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• pp.61-65
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• 1989

Chloroma is a localized myeloblastic tumor which may develop during the course of myelogenous leukemia or as a presenting sign of the disease. A 47-year-old female diagnosed as chronic myelogenous leukemia in her hematologic remission period complained of left lower leg pain. The lumbar-spine series showed multiple osteolytic changes in the left lateral border of the lumbar spine. An inhomogenous soft tissue mass involving left lateral aspects of lumbar vertebrae was identified by CT-scanning. At the first pain attack, lumbar epidural steroid and local anesthetic injection could abolish her pain and the patient could go a few days without pain. The following radiation therapy could also improve the symptom and retain the pain free interval. One month later, a second pain attack occurred and lumbar and caudal epidural steroid and local anesthetic injections could result only in an incidental relief of pain. Radiation and chemotherapy were started but failed to relieve pain. A neurolytic block was considered but the patient's general condition was aggravated and even verbal communication with her became impossible.

• Journal of Veterinary Clinics
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• v.34 no.2
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• pp.103-107
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• 2017

A 7-year-old spayed female Shih-tzu dog with 4-month history of anorexia and weight loss was diagnosed with splenic hemangiosarcoma. One week after splenectomy, the dog developed severe, multifocal, coalescing erosive and ulcerative dermatosis with epidermal collarettes and crusts on the dorsal trunk. The dog was prescribed systemic antibiotics comprising cephradine and enrofloxacin postoperatively. Histopathological examination of skin biopsies from haired skin lesions revealed changes consistent with pemphigus foliaceus (PF). Tentative diagnosis for this patient was pemphigus-like drug reaction resulting from cephradine treatment. However, given the dog's history of hemangiosarcoma, paraneoplastic pemphigus (PNP), a rarely reported cancer-related pemphigus in dogs, was also considered for tentative diagnosis. Significant clinical remission of dermal lesions was achieved with four weeks of prednisolone and mycophenolate mofetil (MMF) treatment. Drugs were gradually tapered and eventually discontinued with concurrent reduction of dermal lesions, and no further recurrence was noted.

• Journal of Breast Disease
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• v.6 no.2
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• pp.46-51
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• 2018

Purpose: Endocrine therapy is the preferred treatment for hormone receptor (HR)-positive metastatic breast cancer (MBC). We investigated the efficacy of combined aromatase inhibitor (AI) and luteinizing hormone-releasing hormone (LHRH) agonist in premenopausal patients with HR-positive MBC. Methods: We retrospectively analyzed the medical records of 21 HR-positive premenopausal MBC patients treated with combined AI and LHRH agonist therapy. Results: The median follow-up period was 32.9 months. The overall response rate was 47.6%, with three complete responses (14.3%) and seven partial responses (33.3%). Nine patients (42.9%) achieved stable disease lasting more than 6 months; thus, the clinical benefit rate was 90.4%. The median time to progression was 45.4 months. No patients experienced grade 3 or 4 toxicity. Conclusion: Combined AI and LHRH agonist treatment safely and effectively induced remission or prolonged disease stabilization, suggesting that this could be a promising treatment option for HR-positive premenopausal patients with MBC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.90-97
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• 2019

Crohn disease has a wide spectrum of clinical presentations and rarely can present with complications such as a bowel stricture or fistula. In this case report, we describe a 17-year-old male who presented with a history of recurrent anterior abdominal wall abscesses and dysuria. He was diagnosed with Crohn disease and also found to have a fistulous communication between the terminal ileum and a patent urachus. An ileocecectomy with primary anastomosis and complete resection of the abscess cavity was performed. He is on azathioprine for maintenance therapy and currently in remission. Clinicians should have a high index of suspicion for this complication in Crohn disease patients presenting with symptoms suggestive of urachal anomalies such as suprapubic abdominal pain, dysuria, umbilical discharge, and periumbilical mass.

• Journal of Medicine and Life Science
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• v.16 no.2
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• pp.46-51
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• 2019

Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.

• Journal of Veterinary Clinics
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• v.36 no.3
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• pp.180-183
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• 2019

A 7-year-old, male Maltese dog with a body weight of 2.8 kg was presented with a history of hind limbs ataxia that progressed to tetraparesis over a one-month period. Based on physical and neurological examinations, tetraparesis with concomitant UMN signs, kyphosis and severe neck pain were identified. On MRI scan, we tentatively diagnosed this patient as a primary intramedullary spinal cord tumor. Therapy with lomustine plus hydroxyurea and prednisolone was initiated and the clinical signs rapidly improved. The patient was regularly checked by MRI scan and the range of the mass was gradually reduced to complete remission for 11 months. About 19 months after treatment, the patient showed anemia and hematochezia which suspected as adverse effects of chemotherapy. The condition was getting worse over 2 months and the patient suddenly expired 657 days after initial presentation. On histopathological examination, the spinal cord sample was identified as a neuronal atrophy without evidence of tumor cell.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.73-78
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• 1996

From June 1989 to May 1994, 23 patients with myasthenia gravis underwent thymectomy in the Department of Thoracic Surgery, Asan Medical Center. For the evaluation of the effect of thymectomy, clinical analysis including age and sex distribution, preoperative disease severity, duration of the symptoms, thymic pathology, and postoperative clinical improvement was performed. The mean follow-up period was 15 mon hs(range : 5∼60mon1hs). The effectiveness of thymectomy according to the postoperative symptoms and drug dose was graded as follow : a) complete remission in 5 cases (21.7%), b) clinical improvement with dose reduction in II cases (47.9%), c) clinical improvement without dose reduction in 3 cases(13.0%), 4) unchanged in 2 cases (8.8%), e) early death in 1 case(4.3%) and f) recurrence in 1 case(4.3%). According to the preoperative disease stage by Modified Osserman classification, 6(66.7%) of the 9 patients in stage I and 13 (92.9%) of 14 patients in stage II were clinically improved after thymectomy. although there was no significant statistical differences between these two groups (p> 0.05). According to the thymic pathology, 4 (100%) of 4 cases with normal thymus were clinically improved. Ten (90.9%) of 11 cases with thymic hyperplasia and 5 (62.5%) of 8 cases with thymoma were clinically improved, but there was no significant statistical differences in these three groups (p> 0.05 . The thymectomy resulted in dramatic clinical improvement in 19 (82.5%) out of 23 patients. According to the preoperative disease stage by Modified Osserman classification or the thymic pathology, there was no significant statistical differeneces in the effect of thyinectomy (p> 0.05).

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5741-5746
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• 2012

Aim: Although preoperative chemoradiatherapy (CRT) has proven its benefits in terms of decreased toxicity, there is still a considerable amount of cases that do not receive postoperative CRT. Oncologists at different geographic locations still need to know the long-term effects of this treatment in order to manage patients successfully. The current paper reports on long-term quality of life (QOL) and late side effects after adjuvant CRT in rectal cancer patients from 5 centers in Anatolia. Methods: Rectal cancer patients treated with postoperative CRT with minimum 1-year follow-up and were in complete remission, were evaluated according to RTOG and LENT-SOMA scales. They were also asked to complete Turkish version of EORTC QLQ-C30 questionnaire and the CR-38 module. Each center participated with the required clinical data. Results: Two hundred and thirty patients with median age of 55 years participated and completed the study. Median follow-up time was 5 years. All patients received RT concomitant with chemotherapy. Common parameters that both increased functional health scales and yielded better symptom scores were long term interval after treatment and sphincter-saving surgery. In addition, surgery type and follow-up time were determined to be predictors of QOL scores and late toxicity grade. Conclusion: Postoperative CRT was found to have a great impact on the long term QOL and side effects in rectal cancer survivors. The factors that adversely affect these are abdominoperineal resection and shorter interval. The findings may encourage life-long follow-up and cooperation with patients, which should be mentioned during the initial counseling.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1971-1976
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• 2015

Background: To evaluate our results in terms of response, survival and toxicity profile of sunitinib among Egyptian patients with metastatic renal cell carcinoma. Materials and Methods: Between January 2010 and December 2013, 44 patients with metastatic renal cell carcinoma who received sunitinib at an oncology center of Cairo university hospitals were enrolled in this retrospective analysis. Results: The median age of the patients was 53 years, 22 (50%) having localized disease at presentation, while the remaining half of the patients presented with metastasis. At a median follow up of 19 months, 9 (21%) patients achieved partial remission, while disease was reported stable in 20 cases (45%) and progressive in 7 (16%), 4 (9%) being lost to follow up, and 4 (9%) had discontinued therapy due to toxicity. The median overall survival was 23 months (95%CI 15.2 - 30.9), while progression free survival was 12 months (95%CI 11.6 - 12.3). The most commonly reported non hematological grade 3 adverse events included mucositis (15.9%), hand-foot syndrome (13.6%), and fatigue (9%), while the predominant grade 3 or 4 laboratory abnormalities were neutropenia (6.8%), followed by anemia in 4.5% of patients. Conclusions: Our efficacy data were comparable to the published literature in terms of progression free survival and overall survival, while toxicity profile is different from Asian and western countries. However, sunitinib adverse events were manageable and tolerable in most of our Egyptian patients.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.216-219
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• 2000

Small cell carcinoma usually occurs in lung, but extrapulmonary small cell carcinomas can occur in any sites of body. Most sites of extrapulmonary small cell carcinoma reported were esophagus. And small cell carcinomas occurred in head and neck area were reported rarely. Extrapulmonary small cell carcinoma could be diagnosed when there is no evidence of primary lung lesion on chest X-ray, CT scan of chest and bronchoscopy. The authors experienced a case of small cell carcinoma of left submandibular lymph node in 64-year-old male patient. Biopsy specimen showed poorly differentiated carcinoma but immunohistochemical study showed small cell carcinoma. The chest X-ray and CT scan of chest showed no evidence of primary lung lesion. The patient received chemotherapy(etoposide plus cisplatin) and concurrent chemoradiotherapy using weekly taxol which resulted in good clinical remission. He is still alive 8 months after diagnosis without evidence of lung disease. We report our case with a brief review of literatures.