Primary extracranial neuroblastoma with central nervous system metastases characterization by clinicopathologic findings and neuroimaging

Article Abstract:

Neuroblastoma is a childhood tumor which arises from peripheral neuroblasts, the cells which form the peripheral nervous system during development. Commonly, the neuroblastoma arises from the same cells that form the adrenal medulla, a gland that is an important part of the sympathetic nervous system. Neuroblastoma does not occur within the brain and spinal cord, but these tissues may be affected by metastatic spread of the neuroblastoma. It is generally believed that when the brain or spinal cord is affected it is due to the extension of a metastatic neuroblastoma growing in an adjacent structure, such as bone. Until recently, it has been thought that the development of central nervous system (CNS) relapse in a child with neuroblastoma was an exceedingly grim sign. Six cases are now reported in which the prompt recognition and treatment of CNS involvement resulted in complete responses in four patients. In one of these patients the response continues to persist after more than five years. Two other patients were treated more recently and they continue to enjoy complete responses more than five and 27 months after CNS relapse from neuroblastoma. In a review of 160 cases of neuroblastoma, CNS involvement was identified in eight; two additional cases from another medical center were included in the present review. In four of the 10 cases, the disease was already too far advanced for any treatment attempt; these patients died within a week of presentation. The remaining six patients were treated with either radiation or chemotherapy containing platinum (such as cisplatin), or both. These cases illustrate that although CNS involvement of neuroblastoma is indeed a serious condition, treatment may nevertheless result in durable responses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Neuroblastoma, Nervous system cancer

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Regression of hepatic metastases from gastrointestinal leiomyosarcoma after hepatic arterial chemo-embolization

Article Abstract:

Leiomyosarcoma is a cancer of smooth muscle cells. Gastrointestinal leiomyosarcoma, which arises in the layers of smooth muscle surrounding the digestive tract, affects about 1,000 new patients each year in the US. Patients rarely survive more than five years. Unlike some cancers, which spread to a number of distant sites, gastrointestinal leiomyosarcoma spreads predominantly to the liver, and most patients die of liver failure. Unfortunately, gastrointestinal leiomyosarcoma has proved to be relative resistant to chemotherapy. In two recent cases, a new surgical technique was used to palliate the symptoms of metastatic leiomyosarcoma in the liver. The encouraging results suggest that the treatment may prove able to lengthen survival as well. The patients were treated by carefully placing a catheter into the artery feeding the affected area within the liver. A mixture of cisplatin, a chemotherapeutic agent, and polyvinyl polymer was injected. The polyvinyl polymer consisted of tiny particles about 150 millionths of a meter in size, which is sufficient to block small arteries. The technique, called chemo-embolization, was then followed with the infusion of vinblastine, another chemotherapeutic agent. Both patients experienced significant symptomatic relief. One patient was able to take up sports again, including triathlon competition. The symptomatic relief was reflected in regression of the tumor visible on CT scans. Unfortunately, the improvement was not permanent, and the two patients experienced tumor progression after remissions of five and 18 months. However, since liver failure is the common cause of death in these cases, it may be found that this will treatment improve survival rates. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Dosage and administration, Chemotherapy, Liver cancer, Leiomyosarcoma, Hepatic artery

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