69-year-old male found on colonoscopy to have multiple polyps and a rectal cancer. He underwent preoperative chemoRT, underwent resection and received a single cycle of bolus 5-FU with leucovorin. In early 2007, he had multiple complications and ultimately has a permanent ileostomy. Scans over the next few years have demonstrated nonspecific findings in his thorax however in July 2008 he had a mesenteric mass with adenopathy. These lesions had FDG uptake on PET scan.
A 74 years old male was diagnosed 3 years ago with non small cell lung carcinoma. Accordingly, it was decided that no chemotherapy should be given at that stage. Year and a half later, a new SOL was found in right lung, and right pneumonectomy was performed. On pathology a well to moderately differentiated adenocarcinoma was found. Lymphatic invasion was identified in lung and mediastinum. A revision on previous specimen was performed and it was concluded that the tumor was morphologically different from the previous specimen.
36-year-old otherwise healthy female presented with an atypical pap smear. Biopsy of cervix revealed poorly Differentiated Neuroendocrine Carcinoma. Immunohistochemical staining showed the cells positive for NSE, SYN, CHR, and 90% positive for Ki67 (proliferative index). The findings of the PET-FDG test showed pathological absorption of FDG as a primary tumor of the cervix, towards the left side of the body. Moreover, evidence is seen of nodal metastatic spread in the retroperitoneum and pelvis, mainly on the left.
A 66 year old man that was diagnosed with prostate cancer underwent radical prostatectomy 2 years ago. Pathology result of the surgical specimen revealed poorly differentiated prostate carcinoma with positive surgical margins. He was treated with antiandrogens and adjuvant radiation therapy. Since the beginning of the last year and under hormonal monotherapy with Casodex his PSA levels doubled. PET CT of the abdomen and the pelvis revealed hepatic lesion.
A 58 year-old woman who first presented for evaluation of a bleeding pigmented lesion on the back. An excisional biopsy was performed and revealed a nodular melanoma. A wide excision was performed and no residual melanoma was identified. After a sentinel lymph node biopsy found to be positive, a completion of node dissection was performed and on pathological evaluation, total 6 of 17 lymph nodes contained melanoma.
Staging studies included whole body PET/CT scan and a head CT. FDG uptake by PET was noted in the left axilla only, with no evidence of more distant metastatic disease.
36-year-old otherwise healthy female underwent routine tests that found atypical cells in Pap smear. Her cervix was biopsied, and found poorly differentiated neuroendocrine carcinoma. The findings of the PET-FDG test showed pathological absorption of FDG as a primary tumor of the cervix, towards the left side of the body. Moreover, evidence is seen of nodal metastatic spread in the retroperitoneum and pelvis. In the expert's opinion the patient has locally extensive small cell neuroendocrine carcinoma of the cervix with extensive pelvic and PA adenopathy.
67-year-old with multiple co morbities: Heart, renal, vascular, hypertensive. His biopsy showed left lower lobe lung mass that was a TTF-1 Non small cell lung cancer- most likely an adenocarcinoma. Multiple small nodules < than 1cm were noted without certain etiology, together with “masses” in the upper abdomen and left arm. Recommended therapy includes single agent Vinorelbine.
Adult male with a history of hepatitis C, non-Hodgkin’s lymphoma (NHL) and hepatocellular carcinoma. Patient treated for NHL with CHOP-R 4 years ago. However, post-treatment, he had continued presumed bone marrow suppression. He was diagnosed 2 years later with HCC and underwent TACE with good effect. Since the TACE, the patient has had persistent and worsening hepatic dysfunction with portal hypertension and ascites. Recently, the patient developed encephalopathy and was treated, as described below, with fast return to consciousness.
66-year-old female was diagnosed, following persistent cough, with non-operable tumor of her lung with satellite nodules, and chemotherapy was initiated (first Cisplatin and Gemcitabine, and then switched to Tarceva). Response evaluation following the fourth cycle of chemotherapy showed either stability or an initiation of tumor response, but bone scintigraphy that was performed 6 months later revealed an area of increased uptake in the left hemithorax which could be suggestive of a secondary bone lesion.
An occasion chest X-ray of a 74-year-old female revealed a thickening in her left lung, and the tumor was latter typified as non-small cell lung cancer. Her staging chest CAT scan was consistent with a primary tumor in the lingular sub-segment together with millimetric parenchymal nodules suspected as secondary. She underwent a lingular segmental resection of the left lung. The histological report described a mixed acinar and non-mucinous bronchoalveolar adenocarcinoma of the lung.
A 58 years old male. 4 years ago the patient was hospitalized due to acute thrombosis of the right femoral-iliac axis. The patient was treated succesfully with locoregional intra-arterial fibrinolytic therapy. A follow-up arteriography, revealed sub-occlusion of the common iliac, occlusion of the right superficial femoral artery in Hunter’s canal. PTA + stent of the iliac was carried out with excellent final angiographic result.
26-year-old patient was diagnosed with stage 4 melanoma with massive metastatic spreading around the lymph node, and underwent surgical treatment: radical lymphoadenectomy of the right armpit, splenectomy, and resection of two subcutaneous lesions. Chemotherapy is also planned.
74-year-old women with thickening in the left lung. The tumor was typified as non-small cell lung cancer (NSCLC) with millimetric parenchymal nodules suspected as secondary. She underwent a lingular segmental resection.
52-year-old male was diagnosed in 2004 with a carcinoma of the lower rectum and underwent surgical anterior resection of the rectal tumor which was a well differentiated adenocarcinoma. In 2008 he underwent emergency operation for a perforated pyloric ulcer and then a radical resection of a gastric tumor which infiltrated the entire thickness of the gastric wall. It was a G3 diffuse type adenocarcinoma with signet ring cells, at pT3N2 stage.
58-year-old male suffers from advanced metastatic colon cancer with weakness, severe anemia and synchronic liver metastases. A good partial response has been accomplished by the combination chemotherapy and the antiangiogenic antibody Avastin. In the meantime, the patient has been started on a therapeutic protocol based on hyperthermia. In the expert's opinion, There is no evidence that hyperthermia is of any benefit in this patient.
A 61 year old male who presented with an epileptic episode was evaluated. A temporo-parietal-occipito mass was detected on MRI and PET CT. A follow-up MRI one year later showed progression of the lesion. One month later he had a craniotomy and what seems to be a partial removel of the mass. The pathology revealed glioblastoma. He was scheduled for radiotherapy two months later. The post operative MRI showed post operative changes including blood at the surgical cavity. However, there is a significant residual tumor present which is enhancing following administration of contrast.
The expert shares broad information regarding Cystic neoplasms of the pancreas: categories, symptoms, diagnosis, treatment, risks and outcomes, and qualifications for performing surgery on the pancreas.
51-year-old male with past medical history that is remarkable for Sino-nasal adenocarcinoma which was resected 13 years ago, and a recurrent local tumor which was re-operated. Since late 2007, the patient has been noticed to have mild macrocytic anemia and leucopenia, and the hematologist thought it might represent a myelodysplastic syndrome.
47-year-old male presented with un-provoked portal and mesenteric vein thrombosis that caused persistent radiating pains of upper abdominal quadrants. The examinations found heterozygous factor II mutation, and family survey for the factor II mutation was recommended. The patient started anticoagulant therapy. In the expert's opinion, the main risk factors for portal vein thrombosis are: Prothrombotic disorder, abdominal inflammation, cirrhosis, cancer, abdominal intervention and abdominal infection.