International Journal of Advances in Medicine最新文献_第3页

A case of tuberculous peritonitis accompanied by tuberculous pleuritis 一例结核性腹膜炎伴结核性胸膜炎病例

International Journal of Advances in Medicine Pub Date : 2024-02-22 DOI: 10.18203/2349-3933.ijam20240361

Larasati A. Wahyu, Pramarta Y. Dwiputra

{"title":"A case of tuberculous peritonitis accompanied by tuberculous pleuritis","authors":"Larasati A. Wahyu, Pramarta Y. Dwiputra","doi":"10.18203/2349-3933.ijam20240361","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20240361","url":null,"abstract":"Tuberculous peritonitis is a form of extrapulmonary tuberculosis, a peritoneal or visceral inflammation caused by Mycobacterium tuberculosis. The disease is rarely independent, but is usually a continuation of the tuberculosis process elsewhere, especially pulmonary tuberculosis. We report a case of TB peritonitis accompanied by TB pleurisy, a 29-year-old female patient with complaints of an enlarged abdomen, heartburn, fever, diarrhea, and decreased appetite. Treatment history was Acitral, Zinc, and Metronidazole. On physical examination, it was found that the general condition was weak and the axilla temperature was 39.5ºC. Thorax examination; decreased vesicular sound on the left chest. Abdominal examination; found distension, epigastric tenderness, undulation, shifting dullness, checkerboard phenomenon, and increased bowel noise. Laboratory examination of complete blood; within normal limits. Complete stool; yellow color, mucus (+), leukocytes 4-6/LPB, bacteria (+). The thorax photo showed left pleural effusion, BOF 3 position: ascites. Abdominal ultrasound results: thickening of the peritoneum, ascites, suspected TB peritonitis. Results of ascites and pleural fluid analysis: rivalta (+) and Adenosine Deaminase (ADA) increased. So that from anamnesis, physical examination, supporting examination can be established diagnosis of TB Peritonitis and TB Pleuritis, followed by OAT therapy; FDC for 12 months. From this case it can be concluded that clinical and supporting examinations (radiology) are needed to make a correct diagnosis and body fluid analysis examinations can help confirm the diagnosis.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"86 1‐4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Orbital pseudolymphoma: a benign condition mimicking malignancy 眼眶假淋巴瘤：一种模仿恶性肿瘤的良性病症

International Journal of Advances in Medicine Pub Date : 2024-02-22 DOI: 10.18203/2349-3933.ijam20240362

N. Kasturi, Salwa Kaidakath, Mary Stephen, J. P.

引用次数: 0

The use of intra-aortic balloon pump in cardiac surgery 在心脏手术中使用主动脉内球囊泵

International Journal of Advances in Medicine Pub Date : 2024-02-17 DOI: 10.18203/2349-3933.ijam20240329

Bashar Alqudah, Wael Alshobaki, Suhaib Alghawanmeh, Hamza Abuamira, Hamzeh A. Alhrahsheh, Sakher A. Alsharo, Ashraf F. Mohommad

{"title":"The use of intra-aortic balloon pump in cardiac surgery","authors":"Bashar Alqudah, Wael Alshobaki, Suhaib Alghawanmeh, Hamza Abuamira, Hamzeh A. Alhrahsheh, Sakher A. Alsharo, Ashraf F. Mohommad","doi":"10.18203/2349-3933.ijam20240329","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20240329","url":null,"abstract":"Background: Objective of the study was to determine the incidence of use, indications, complications of intra-aortic balloon pump (IABP) and its impact on outcome.\u0000Methods: Retrospective study of adult cardiac surgical patients presenting for cardiac surgery at Queen Alia Heart Institute in the period of time between September 2023 and February 2024. Patients’ demographic, clinical, perioperative data were recorded and analysed. Time of initiation of intra-aortic balloon, indications and monitoring for complications were observed by the authors. Patients were divided into two groups according to the use of IABP; the IABP group and the non-IABP group. Both groups were compared regarding outcome. Ethical committee approval obtained.\u0000Results: Data from 202 adult cardiac surgeries was analysed. Average age of patients was 57.2 years. Patients were 34 females (16.8%) and 168 males (83.2%). Most surgeries were elective (93.6%), while urgent surgeries comprised 3.5% and emergency surgeries were 3%. Coronary artery bypass grafting (CABG) was the most common procedure (78.2%). The IABP was most commonly used after combined procedures (50%) and to a lesser extent after isolated CABG (15.3%). IABP was inserted least frequently pre-operatively (10.7%), followed by postoperative insertion (35.7%), while intraoperative insertion to aid weaning from CPB was most common (53.6%). Patients from the IABP group were older, had longer CPB time (136.7 minutes) and AXC times (70.5 minutes), they also spent around 2 days more in the ICU and around 4 days more in hospital.\u0000Conclusions: IABP was most commonly utilised for combined procedures, after prolonged CPB and aortic cross clamping. The use of IABP was associated with delayed tracheal extubation, longer ICU stay, longer hospitalisation, and higher rates of blood transfusion, higher incidence of re-opening and higher mortality.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"90 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139959426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous tension pneumothorax: a devastating consequence of pulmonary tuberculosis 自发性张力性气胸：肺结核的破坏性后果

International Journal of Advances in Medicine Pub Date : 2024-02-08 DOI: 10.18203/2349-3933.ijam20240315

Yolanda Kadir, Elok Ariyani Safitri

{"title":"Spontaneous tension pneumothorax: a devastating consequence of pulmonary tuberculosis","authors":"Yolanda Kadir, Elok Ariyani Safitri","doi":"10.18203/2349-3933.ijam20240315","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20240315","url":null,"abstract":"Tuberculosis (TB) was the world’s second leading cause of death from a single infectious agent, with mortality reaching 50% in untreated cases. It has been acknowledged as a potential cause of secondary spontaneous pneumothorax. A 57-year-old male presented to emergency department due to shortness of breath since 12 hours before admission. He had a history of chronic cough along with significant weight loss. He was cachexic and fully alert, with normal blood pressure, tachypnea, and slight tachycardia. Decreased breath sounds on the right hemithorax was noted. Chest x-ray revealed right tension pneumothorax and active pulmonary TB. Emergency needle decompression was performed with 14-gauge intravenous catheter. Unfortunately, he died eight hours later following a cardiac arrest. Occurrence of spontaneous tension pneumothorax in TB involves several mechanisms such as pleural porosity, chronic inflammation, and alveolar rupture. Compensatory mechanisms including gradual tachycardia, respiratory rate elevation, along with increasingly negative contralateral intrathoracic pressures could preserve venous return, serving as protective factors against hypotension until the late stages. Late presentation of 12 hours after the first onset might contribute to enormous air leak that could not be effectively managed by needle decompression. Undiagnosed and untreated TB could lead to morbid consequence such as tension pneumothorax, highlighting the importance of TB detection within the community. Clinicians should be aware of variations in the clinical presentation of tension pneumothorax as compensatory mechanisms may hinder the diagnosis at initial presentation. Strategic approaches are imperative to reinforce our commitment to eliminate TB by 2030.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"77 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139853677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous tension pneumothorax: a devastating consequence of pulmonary tuberculosis 自发性张力性气胸：肺结核的破坏性后果

International Journal of Advances in Medicine Pub Date : 2024-02-08 DOI: 10.18203/2349-3933.ijam20240315

Yolanda Kadir, Elok Ariyani Safitri

{"title":"Spontaneous tension pneumothorax: a devastating consequence of pulmonary tuberculosis","authors":"Yolanda Kadir, Elok Ariyani Safitri","doi":"10.18203/2349-3933.ijam20240315","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20240315","url":null,"abstract":"Tuberculosis (TB) was the world’s second leading cause of death from a single infectious agent, with mortality reaching 50% in untreated cases. It has been acknowledged as a potential cause of secondary spontaneous pneumothorax. A 57-year-old male presented to emergency department due to shortness of breath since 12 hours before admission. He had a history of chronic cough along with significant weight loss. He was cachexic and fully alert, with normal blood pressure, tachypnea, and slight tachycardia. Decreased breath sounds on the right hemithorax was noted. Chest x-ray revealed right tension pneumothorax and active pulmonary TB. Emergency needle decompression was performed with 14-gauge intravenous catheter. Unfortunately, he died eight hours later following a cardiac arrest. Occurrence of spontaneous tension pneumothorax in TB involves several mechanisms such as pleural porosity, chronic inflammation, and alveolar rupture. Compensatory mechanisms including gradual tachycardia, respiratory rate elevation, along with increasingly negative contralateral intrathoracic pressures could preserve venous return, serving as protective factors against hypotension until the late stages. Late presentation of 12 hours after the first onset might contribute to enormous air leak that could not be effectively managed by needle decompression. Undiagnosed and untreated TB could lead to morbid consequence such as tension pneumothorax, highlighting the importance of TB detection within the community. Clinicians should be aware of variations in the clinical presentation of tension pneumothorax as compensatory mechanisms may hinder the diagnosis at initial presentation. Strategic approaches are imperative to reinforce our commitment to eliminate TB by 2030.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139793741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comorbidities in adult cardiac surgical patients 成人心脏手术患者的合并症

International Journal of Advances in Medicine Pub Date : 2024-01-23 DOI: 10.18203/2349-3933.ijam20240032

Abdallah Alhadidi, Dya Adeen Al Smadi, Wael Alshobaki, Ahmad Alawamleh, Suhaib Al Ghawanmeh, Ashraf Fadel Mohammad

{"title":"Comorbidities in adult cardiac surgical patients","authors":"Abdallah Alhadidi, Dya Adeen Al Smadi, Wael Alshobaki, Ahmad Alawamleh, Suhaib Al Ghawanmeh, Ashraf Fadel Mohammad","doi":"10.18203/2349-3933.ijam20240032","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20240032","url":null,"abstract":"Background: The objective of this study was to describe the prevalence of comorbidities in adult cardiac surgical patients and their impact on post-operative outcomes.\u0000Methods: This was an observational analysis of patients presenting for cardiac surgery at Queen Alia Heart Institute in the period between September 2023 and January 2024. Patients’ demographics, comorbidities, type of surgery (cardiac pathology), intensive care unit and hospital length of stay were analysed. Patients were divided into four groups according to their number of extra cardiac comorbidities: Group 0 with no comorbidities, group 1 with 1 comorbidity, group 2 with 2 comorbidities and group 3 with more than 2 comorbidities. These groups were compared in relation to extubation time, intensive care unit length of stay, hospital stay and mortality.\u0000Results: Data from 152 adult cardiac surgical patients who underwent 159 procedures was analysed. Male patients were 123 (80.9%). Average age of patients was 57 years and 32 patients (21%) were over 65 years. Most common procedure was CABG 130. Most common comorbidities were: hypertension as 113 (74.3%), diabetes 81 (53.26%), obesity 57 (37.5%), smoking history or respiratory disease 106 (69.73%), peripheral vascular disease 5 (3.29%), renal failure 4 (2.63%). The average Euroscore was 5.25%. Majority of patients 59.9% had more than two extra cardiac comorbidities. Time of tracheal extubation increased from 8.2 hours in group 0 to 18.4 hours in group 3. Mortality increased from 0% in group 0 to 12.1% in group 3.\u0000Conclusions: Most of the cardiac surgical patients present with more than two extra cardiac morbidities. As the number of preoperative comorbidities increases; the longer is the duration of postoperative mechanical ventilation and the mortality.\u0000 ","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139605746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The use of cell salvage in adult cardiac surgery at Queen Alia Heart Institute 阿丽雅王后心脏研究所在成人心脏手术中使用细胞挽救术

International Journal of Advances in Medicine Pub Date : 2024-01-11 DOI: 10.18203/2349-3933.ijam20240015

Dya D. Alsmadi, Abdallah Alhadidi, Ahmad Alawamleh, Suhaib Alghawanmeh, Wael Alshobaki, A. F. Mohd

{"title":"The use of cell salvage in adult cardiac surgery at Queen Alia Heart Institute","authors":"Dya D. Alsmadi, Abdallah Alhadidi, Ahmad Alawamleh, Suhaib Alghawanmeh, Wael Alshobaki, A. F. Mohd","doi":"10.18203/2349-3933.ijam20240015","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20240015","url":null,"abstract":"Background: Objective of the study was to determine the incidence of use cell salvage, indications, efficacy in blood conservation and benefits on recovery after adult cardiac surgery.\u0000Methods: This is an observational analysis of adult cardiac surgical patients presenting for cardiac surgery at Queen Alia Heart Institute in the period between September 2023 and December 2023. Patients’ demographics, type of surgery (cardiac pathology), comorbidities, preoperative and postoperative laboratory results, blood transfusion requirements, extubation and intensive care unit (ICU) length of stay were recorded and statistically analysed to determine the effectiveness of cell salvage. Patients were divided into two groups: The cell saver group and the no cell saver group for comparison.\u0000Results: Data from 141 adult cardiac surgeries is included in this analysis. Indications for cell saver use were recent anticoagulation (41.4%), more complex surgery (20.7%), high risk of bleeding (13.8%), preoperative anaemia (6.9%), intraoperative major bleeding (6.9%), coagulopathy (6.9%) and rare patient blood type (3.45%). Patients from the cell saver group required blood transfusion 2.1% more than the no cell saver group. There was no significant difference in the length of hospitalization between those who had and those who had not cell saver used during surgery (11.9 and 12 days, respectively).\u0000Conclusions: Cell saver was used in one fifth of adult cardiac surgeries. Most common indications for cell saver use during cardiac surgery were recent anticoagulation and more complicated cardiac surgery. The use of cell saver had no impact on postoperative haematocrit or overall time of hospitalization.\u0000 ","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":" 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical validation of artificial intelligence-based cataract screening solution with smartphone images (Logy AI cataract screening module) 利用智能手机图像对基于人工智能的白内障筛查解决方案（Logy 人工智能白内障筛查模块）进行临床验证

International Journal of Advances in Medicine Pub Date : 2024-01-06 DOI: 10.18203/2349-3933.ijam20240007

Mano Aarthi V. M., Nivedita Tiwari, Vinay Khobragade, Mitali Pareek, Anand Panchbhai, Priyanjit Ghosh, Jayachandhran Saravanan

{"title":"Clinical validation of artificial intelligence-based cataract screening solution with smartphone images (Logy AI cataract screening module)","authors":"Mano Aarthi V. M., Nivedita Tiwari, Vinay Khobragade, Mitali Pareek, Anand Panchbhai, Priyanjit Ghosh, Jayachandhran Saravanan","doi":"10.18203/2349-3933.ijam20240007","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20240007","url":null,"abstract":"Background: Purpose of the study was to clinically assess the accuracy of Logy AI cataract screening solution, an artificial intelligence-based module, which works through WhatsApp and also as a separate smart phone application, that can detect cataracts using images taken by a smartphone camera, by comparing with slit lamp based diagnoses made by ophthalmologists.\u0000Methods: A prospective clinical study was conducted in an eye clinic of a tertiary care hospital in the southern part of India with 437 patients. Smartphone images taken were sent to the Logy AI cataract screening solution which predicted if the patient had cataract or not. It graded cataracts as immature and mature. Patients were examined by ophthalmologists with slit-lamp and diagnosis was documented. Both were compared.\u0000Results: 794 eye images were included in the study. The overall accuracy of the AI screening solution for cataract detection was computed to be 90.08%. Further, the accuracy was 88.02% for immature cataract, 97.16% for mature cataract, and 90.08% normal category. The sensitivity was 90.38%, the specificity was 89.87%, and the F1 score was 87.98%. The positive predictive value was 85.71% and the negative predictive value was 93.29%. Logy AI cataract prediction module’s AUC (0.8946) falls under the good category.\u0000Conclusions: Logy AI cataract screening module could work as an effective cataract screening tool at the community level in remote areas where there is no expensive equipment and ophthalmic health care workers considering the accuracy and efficiency to work in low resource settings. It can also be a good home screening tool suitable for the post-COVID era.\u0000 ","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"60 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intraoperative haemofiltration during on-pump cardiac surgery at Queen Alia Heart Institute 阿丽雅王后心脏研究所泵上心脏手术期间的术中血液滤过

International Journal of Advances in Medicine Pub Date : 2024-01-06 DOI: 10.18203/2349-3933.ijam20240008

Ahmad A. Awamlah, Abdallah A. Hadidi, Wael A. Shobaki, Bashar Qudah, Mutaz A. Badaren, Ashraf F. Mohd

{"title":"Intraoperative haemofiltration during on-pump cardiac surgery at Queen Alia Heart Institute","authors":"Ahmad A. Awamlah, Abdallah A. Hadidi, Wael A. Shobaki, Bashar Qudah, Mutaz A. Badaren, Ashraf F. Mohd","doi":"10.18203/2349-3933.ijam20240008","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20240008","url":null,"abstract":"Background: Objective of the study was to determine the frequency, indications and benefits of utilizing haemofiltration during cardiopulmonary bypass in adult cardiac surgical patients.\u0000Methods: This is a prospective observational analysis of data of adult cardiac surgical patients presented for on-pump cardiac surgery in the period between September 2023 and December 2023 at Queen Alia Heart Institute. Data was collected using Google Forms online and was subsequently recorded on Excel sheaths. Patients were divided into two groups: the haemofiltration group and the non-haemofiltration group. Both groups were compared according to perioperative laboratory and clinical variables. Statistical analysis of results using Microsoft excel followed data collection. Ethical committee approval was obtained.\u0000Results: Data from 130 adult cardiac surgical patients (105 males and 25 females) enrolled in this analysis showed that haemofiltration was used in 25 patients (19.2%). The most frequent indication for intraoperative haemofiltration was haemodilution in 14 patients (56%). Blood transfusion was needed in 17 (68%) of patients who had haemofiltration and in 35 (33.4%) of patients who did not need haemofiltration. Patients from the haemofiltration group were extubated 5 hours earlier than patients from the non-haemofiltration group, as the duration of mechanical ventilation in the ICU was 17.9 hours in the haemofiltration group versus 24.9 hours in the non-haemofiltration group. The average overall hospital stay was 3 days less in the haemofiltration group.\u0000Conclusions: Haemofiltration during cardiopulmonary bypass main indications were severe haemodilution, hyperkalaemia and preoperative renal impairment. The use of haemofiltration during CPB was associated with earlier tracheal extubation and shorter hospital stay.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"52 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Local management of unresectable lung atypical carcinoid tumor: a case report and review of literature 无法切除的肺非典型类癌的局部治疗：病例报告和文献综述

International Journal of Advances in Medicine Pub Date : 2023-12-30 DOI: 10.18203/2349-3933.ijam20234162

Joana Martins Pisco, Pedro Miguel Silva, André Pinheiro Figueiredo, Manuel Carmo Silva, Maria Filomena Pina

{"title":"Local management of unresectable lung atypical carcinoid tumor: a case report and review of literature","authors":"Joana Martins Pisco, Pedro Miguel Silva, André Pinheiro Figueiredo, Manuel Carmo Silva, Maria Filomena Pina","doi":"10.18203/2349-3933.ijam20234162","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20234162","url":null,"abstract":"Neuroendocrine tumors comprise a rare but increasing heterogeneous group of malignancies arising from neuroendocrine cells, most commonly from the lung and gastrointestinal tract. Due to the vast histopathological differentiation of each subtype and the scarce clinical data published, choosing the most effective therapy can be challenging. Radiotherapy can play a significant role in the treatment of locally advanced metastatic tumors, however there is a lack of randomized clinical trials in this setting. This article reviews the current knowledge on the classification and treatment of unresectable lung atypical carcinoids. We present a clinical case of a ULAC treated with systemic therapy and RT in different settings of the disease. The subject is a 48 years old male, diagnosed with a well differentiated pulmonary NET, classified as cT4N3M1b (supraclavicular and mediastinal adenopathies and an adrenal metastatic lesion) with disease progression after systemic treatment, and with superior vena cava compression. The primary tumor and involved nodal areas were treated to 54Gy/30 fractions using VMAT. SBRT was given to the metastatic left adrenal gland. Five months after RT, CT showed a volumetric reduction of <25% of the thoracic disease and adrenal gland’s lesion stability. The disease remained stable for the next year and a half, when local and distant progression occurred, starting systemic treatment. A year and a half later, the patient presented with brain metastasis and underwent radiosurgery. At last follow-up, 5 years after diagnosis, the patient maintains treatment with capecitabine and temozolomide and is clinically stable. Definitive RT should be considered in the management of ULAC to improve local control.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0