Embryonal sarcoma of the liver in an adult treated with preoperative chemotherapy, radiation therapy, and hepatic lobectomy

Article Abstract:

Embryonal tumors, which arise from primitive tissues, generally make their presence known in childhood. However, embryonal tumors may be found in adult patients as well. Embryonal sarcoma of the liver is especially uncommon in adults; only eight cases have appeared in the medical literature. There were no long-term survivors among those eight. In a recent case, however, combination therapy has resulted in the long-term survival of a 28-year-old man with embryonal sarcoma of the liver. The patient had a two-month history of pain in the stomach area and had lost 7.7 kilograms (about 17 pounds). A mass could be felt near the stomach, which computed tomography revealed to be a tumor occupying almost all of the entire left lobe of the liver. A fine-needle aspiration biopsy was performed and the examination of the recovered material revealed undifferentiated tumor tissue; this appearance, in combination with patterns of staining using specific antibodies, was consistent with a diagnosis of embryonal sarcoma of the liver. The patient was treated with a chemotherapeutic regimen which has been recommended for high-risk rhabdomyosarcoma, another primitive sarcoma. This regimen included vincristine, cisplatin, doxorubicin, cyclophosphamide, etoposide, and dactinomycin. In addition, the patient received 4,680 cGy radiation therapy. The left lobe of the liver containing the tumor was removed, and microscopic examination of the tumor mass revealed no signs of living cancer cells within the necrotic mass. Although the patient suffered some complications of the chemotherapy and radiotherapy, he has returned to work and at present remains free of disease after 20 months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Liver cancer, Sarcoma, Tumors, Embryonal, Embryonal tumors

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Maternal reproductive history and birth characteristics in childhood acute lymphoblastic leukemia

Article Abstract:

Acute lymphoblastic leukemia (ALL) is the most common cancer among children in the United States. About 2,000 new cases occur each year among children under 15 years. There has been some suggestion that the stage may be set during prenatal life for the development of ALL in childhood. To further examine the relation between prenatal life and the development of ALL, a study was conducted of the birth records and maternal histories of 337 children with ALL and 1,336 control cases without ALL matched for year of birth. The likelihood of ALL was found to be greater among children born to women who were older than 35 years at the time of delivery. Mothers of ALL patients were also more likely to have had their previous offspring five or more years before the birth of the child with leukemia. Increasing age of the father also appeared to increase the likelihood of ALL, but the effect was not as strong as that of maternal age. Several of the factors associated with ALL were dependent upon the age of the child when ALL was diagnosed. Children diagnosed before two years of age were more likely to be born to women who miscarried on the previous pregnancy. Similarly, when only children diagnosed before the age of four years were considered, there was a significant correlation between developing ALL and having a birth weight greater than 3,800 grams (about 8.2 pounds). These findings do not indicate what aspects of prenatal life actually contribute to increased risk of acute lymphoblastic leukemia in children. The findings do, however, strengthen the suspicion that prenatal factors do play a causative role in at least some cases of ALL. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Demographic aspects, Prenatal influences, Lymphoblastic leukemia in children, Acute lymphocytic leukemia, Childhood leukemia

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Primary hepatic lymphoma in an adolescent treated with hepatic lobectomy and chemotherapy

Article Abstract:

The majority of cases of lymphomas located in the liver have occurred in adults; only two cases in children have been reported. In neither case was treatment with chemotherapy and radiotherapy successful. However, in the case of a 17-year-old boy, extended liver removal and combination chemotherapy appears to have been successful. The patient had developed a mass near the stomach, and was lethargic and had reduced appetite. A CT scan was used to guide a biopsy of the liver mass, but only necrotic (dead) tissue was obtained. The tissue was determined to be malignant, and a preliminary diagnosis was possible undifferentiated embryonal sarcoma. Since there was no evidence of metastatic spread, the patient was deemed to be a good candidate for surgical treatment. The entire left lobe and a portion of the right lobe of the liver were removed. After surgery, the patient was placed on a chemotherapeutic regimen of cyclophosphamide, vincristine, prednisone, and methotrexate. Pathological examination of the removed tissue revealed that the tumor was actually a B-cell non-Hodgkin's lymphoma, a cancer originating in the lymphatic system. The entire literature on primary liver lymphoma consists of 48 cases, which precludes broad generalizations about treatment. However, the patient in this report is alive one year after surgery and appears to be free of disease, suggesting that, when practical, surgery followed by chemotherapy may be an effective treatment for this tumor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Non-Hodgkin's lymphomas, Liver tumors

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