Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Nov 2020
Case ReportsT-Cell Lymphoma Presenting With Bilateral Chylothorax.
Chylothorax is the accumulation of chyle in the pleural cavity due to obstruction or injury arising in the thoracic duct or its large branches. In more than 50% of patients diagnosed with chylothorax, the etiology consists of malignant diseases; and among these, lymphomas are the most common cause, accounting for 60% of cases. We report a case of a 37-year male with T-cell lymphoma who presented with bilateral pleural effusion; pleural fluid analysis confirmed chylothorax. ⋯ Our patient was diagnosed rapidly with both chylothorax and lymphoma. We started the treatment immediately and saved his life. Key Words: Chyle, Chylothorax, Lymphoma.
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J Coll Physicians Surg Pak · Nov 2020
Case ReportsMalignant Melanoma Metastasis to Sigmoid Colon: New Endoscopic Appearance Detected for the First Time.
Malignant melanoma (MM) develops as a result of malignant transformation of melanocytes. It accounts for 4% of all skin cancers. MM metastases usually occur in regional lymph nodes, bones and central nervous system. ⋯ However, in this case, an appearance of 'only submucosal melanosis without mass or nodule' was identified, distinct from previously described three endoscopic views and it was verified histopathologically. This case will help increase awareness of endoscopists in terms of being careful to look for MM metastasis on endoscopic examinations, which may be defined as 4th type of endoscopic appearance. Key Words: Malignant melanoma, Metastasis, Colon, Endoscopy.
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J Coll Physicians Surg Pak · Nov 2020
Meta AnalysisPotentially Resectable mCRC-treated with Cetuximab Combined with Chemotherapy.
Surgical resection of a potentially resectable metastatic colorectal cancer (mCRC) may lead to additional clinical benefits for the patients. In some cases, patients with initially unresectable lesions can be converted to resectable ones after induction of chemotherapy; and these patients are primarily treated with fluorouracil-based systemic chemotherapy preoperatively. However, the optimal protocol for neoadjuvant therapy has not been determined yet, and it remains a source of controversy about whether systemic chemotherapy combined with cetuximab can increase the surgical resection rate and obtain more clinical benefits. ⋯ Compared with patients undergoing chemotherapy, the patients receiving systemic chemotherapy combined with cetuximab of the R0 resection was not improved (OR=1.25; 95% CI, 0.76-2.06; p=0.08); The progression-free survival (PFS) of the patients received chemotherapy combined with cetuximab was slightly longer than those received chemotherapy alone (HR=0.88; 95% CI, 0.77-1; p=0.005); and the overall survival (OS) of patients undergoing systemic chemotherapy combined with cetuximab was not prolonged relative to that in patients receiving chemotherapy alone (HR=0.98; 95% CI, 0.86-1.11; p=0.04). Compared with patients receiving chemotherapy alone, the surgical resection rate and PFS are not increased in patients undergoing chemotherapy combined with cetuximab, but the OS is slightly prolonged. Key Words: Chemotherapy, Cetuximab, Colorectal cancer, Metastatic tumor, Surgery.