A recurrent pelvic desmoid tumor successfully treated with tamoxifen

Article Abstract:

Desmoid tumors are locally invasive and recurrent but benign. These tumors arise from connective tissues associated with muscle, and are relatively rare, occurring in about 3 per million people per year. In many cases, desmoid tumors are hormonally dependent, and the majority occur in women during reproductive years; some desmoid tumors regress during menopause. A case is presented of a patient seen with a rapidly enlarging pelvic mass 10 days after a cesarean section. Exploratory surgery revealed a desmoid tumor, which was removed. The diagnostic of tumor type was confirmed by pathological examination, and the patient was placed on megestrol acetate after surgery. Five months later there was no evidence of tumor, but a mass recurred 12 months after the initial surgery, and CT scan indicated recurrence of the desmoid tumor. The tumor was again removed, and the patient was treated with radiation in the region of the tumor. Four weeks after the irradiation, a tumor mass could again be felt, and the patient was placed on a regimen of tamoxifen, an antiestrogen drug. After three months, the tumor decreased in size, and after six months, was not detectable by pelvic examination. Tamoxifen treatment was continued, but at a reduced dosage. Twenty-seven months after the initiation of tamoxifen treatment, the patient remains well without signs of tumor recurrence. Since desmoid tumors are rare, there is little accumulated experience suggesting the best mode of treatment. However, the success with this patient indicates that tamoxifen should be considered as the first line treatment for such tumors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Chemotherapy, Tamoxifen, Pelvic cancer

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Tumour necrosis factor, cholestatic jaundice, and chronic liver disease

Article Abstract:

Tumor necrosis factor (TNF) is a protein produced by activated macrophages (immune system cells) in response to circulating toxins. One important physiological effect of TNF is to produce necrosis (tissue death) of experimentally induced tumors. With the cloning of the gene for human TNF, large quantities of the substance have become available, and experiments have been carried out investigating its possible use as an anti-cancer agent. The authors discuss previous studies of TNF performed by themselves and others. Complications of this treatment regimen, especially alterations in the levels of liver enzymes, were reported. Patients developed hyperbilirubinemia (high blood levels of bilirubin, a liver bile constituent), as well as jaundice induced by inhibition of bile flow (cholestatic jaundice). The possibility that these effects were caused by spread of the cancer to the liver was ruled out by noting the abatement of liver symptoms with cessation of TNF treatment. Liver biopsies were not performed, so no biochemical or microscopic analysis of liver tissue was possible in these cases. The observations suggest that TNF has direct pathogenic effects on the liver, and the hypothesis is put forward that disruptions in liver function seen in conditions where TNF levels would be increased (following viral infections, in liver failure, and in chronic liver disease) may be directly attributable to TNF. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Abnormalities, Causes of, Complications and side effects, Tumor necrosis factor, Mutation breeding, Jaundice, Liver function tests

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