Bronchoscopic cryosurgery for metastatic tumor causing central airway obstruction: A case report

This report describes the interventional bronchoscopic cryotherapy for a patient with CAO caused by squamous cell carcinoma of the esophagus. We display a series of dramatic change of chest radiographs before and after the intervention. Patient concerns: A 70-year-old man with squamous cell carcinoma of the middle third of the esophagus (initial staging, pT2N0M0; stage IIB; in January 2017) underwent Video-assisted esophagectomy and reconstruction with a gastric conduit via a substernal route. Following Chest computed tomography and positron emission tomography revealed disease progression with paratracheal metastases. Progressive dyspnea and chest pain lasted for a month, and he was admitted to the ER. Diagnoses: Blood gas analysis revealed type I respiratory failure (pH, 7.445; PaO2, 69.4 mmHg; PaCO2, 40.6 mmHg). Other laboratory data were grossly normal. Chest radiography revealed a total left lung collapse. Chest CT identified a tumor blocking the left mainstem bronchus with the consolidation of the left lung. Interventions: Dexamethasone and epinephrine inhalation were administered for initial symptom relief. Bronchoscopy performed 4 days after admission revealed a huge tumor completely occluding the left mainstem bronchus orifice. The occlusion was completely resolved following cryotherapy. Then, the first course of palliative chemotherapy with cisplatin plus fluorouracil, followed by the second course a month later, was administered. Outcomes: The latest ch...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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Abstract There is benefit, risk and cost in all that we do, but when it comes to food, we expect that it will benefit our health, be available, safe to eat and affordable. But as climate change and demographic shifts through displacement and ageing gather momentum, the emphases on each of benefit, risk and cost will alter. That we are ecological beings whose health and wellbeing are ecosystem-dependent, must now be the underpinning framework for risk management. Loss of natural environment and biodiversity represents reduced nutritional and health resilience, which will need to be factored in to risk assessment an...
Source: Asia Pacific Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Asia Pac J Clin Nutr Source Type: research
CONCLUSIONS This study offers a novel 2-gene signature to predict overall survival of patients with HCC, which has the potential to be used as an independent prognostic predictor. Overall, this study reveals more details about the tumor microenvironment in HCC and offers novel candidate biomarkers. PMID: 32231177 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
Purpose of review To compare outcomes of 27-gauge and 23-gauge pars plana vitrectomy (PPV) for treatment of vitreoretinal diseases. Recent findings Sixty-eight patients undergoing microincisional PPV for treatment of vitreoretinal diseases were randomized 1 : 1 to 27-gauge or 23-gauge surgery with a 7500 cuts-per-minute vitrectomy probe. The most common reasons for vitrectomy were epiretinal membrane (49%) and vitreous hemorrhage (24%). Mean ± standard deviation (SD) changes from immediate preoperative to immediate postoperative intraocular pressure were −0.40 ± 6.60 mmHg in the 27-ga...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research
We present a case of a 49-year-old female who consulted for dysphagia, epigastric pain, and anorexia 17  years after LAGB. An esophageal squamous cell carcinoma was diagnosed in the distal esophagus, close to the lap band. The diagnostic value of the performed contrast swallow study seemed limited. We suggest that a routinely gastroscopic evaluation in the long-term follow-up after LAGB should be str ived for in patients presenting with late-onset dysphagia.
Source: Obesity Surgery - Category: Surgery Source Type: research
Description: A 59 year old woman presented with abdominal pain and vomiting. Her past medical history included a T4 N2 M0 infiltrative squamous cell carcinoma of the right upper lobe invading the upper mediastinum, and causing extrinsic compression of the oesophagus. Due to worsening dysphagia she had undergone metallic stent placement 5 months prior to admission. CT scans to monitor response to chemotherapy had shown gradual migration of her stent into the stomach. Plain abdominal x-ray showed the stent to be lying in the pelvis.
Source: International Journal of Surgery - Category: Surgery Authors: Source Type: research
ConclusionSelected stage IV achalasia patients with recurrent and disabling symptoms after previously failed Heller myotomy and/or endoscopic treatments should be offered minimally invasive esophagectomy.
Source: European Surgery - Category: Surgery Source Type: research
We report a case of esophageal cancer that occurred after esophageal rupture was treated with thoracoscopic and laparoscopic surgery. A 76‐year‐old man presented with vomiting followed by epigastric pain and was diagnosed with spontaneous esophageal rupture. Laparoscopic and thoracoscopic surgery were performed. Primary closure was completed with a fundic patch, and thoracic lavage was performed. Ten months later, his condition was diagnosed as squamous cell carcinoma of the abdominal esophagus. He underwent thoracoscopic esophageal resection in the prone position, and a gastric conduit was created laparoscopically. Th...
Source: Asian Journal of Endoscopic Surgery - Category: Surgery Authors: Tags: Case Report Source Type: research
Introduction Oesophageal cancer is the eighth most common cause of cancer worldwide. In 2009 in China, the incidence and death rate of oesophageal cancer was 22.14 per 100 000 person-years and 16.77 per 100 000 person-years, respectively, the highest in the world. Minimally invasive oesophagectomy (MIO) was introduced into clinical practice with the aim of reducing the morbidity rate. The mechanisms of MIO may lie in minimising the reaction to surgical injury and inflammation. There are some randomised trials regarding minimally invasive versus open oesophagectomy, with 100–850 subjects enrolled. To date, n...
Source: BMJ Open - Category: Journals (General) Authors: Tags: Open access, Oncology, Surgery Protocol Source Type: research
Conclusion We describe the first reported case of a patient with esophageal squamous cell carcinoma who showed perforation of IMS during preoperative chemotherapy.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Abstract A male patient in his early seventies complained of swallowing difficulty and back pain. Esophagogastroscopy was performed and the patient was diagnosed as squamous cell carcinoma in the middle and lower part of the esophagus with a longitudinal submucosal elevation of 15 cm and S2 stage of gastric ulcer infected by Helicobacter pylori. Multiple lymph node swelling was detected not only in the mediastinum but also in the neck and the para-aortic area by CT scanning. The clinical stage was T3 N4 M0 Stage IVa. Systemic chemotherapy was applied first and the curative effectiveness was SD based on the RE...
Source: Esophagus - Category: Gastroenterology Source Type: research
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