In and etoposide. A CT scan of the abdomen after chemotherapy > 자유게시판

In and etoposide. A CT scan of the abdomen after chemotherapy showed bulky, centrally necrotic liver metastases with nearly total involvement of the left hepatic lobe and pulmonary metastases within the right lung abutting the mediastinal pleura, indicating an inadequate response to treatment. The patient still had high serotonin and chromogranin A levels (Table 1). Therefore, hepatic artery embolization (HAE) of the right hepatic artery was performed, along with administration of octreotide to mitigate tumor burden from liver metastases. The patient's disease activity decreased, as indicated by the biochemical markers listed in Table 1, although her chromogranin A level was still elevated. One month later, the patient also received embolization of the left hepatic artery with a second dose of octreotide. Her hepatomegaly decreased. Symptomatically, she felt better. Her liver disease responded favorably to embolization. Post-embolization syndrome with nausea and low-grade fever resolved with symptomatic treatment with antinausea medication, hydration and a short-term hospital stay after she underwent a second HAE. At a follow-up examination after her second HAE, the patient complained of pain in her right shoulder, which was graded 5 of 10 in severity with weakness and reduced range of motion. Cryoablation of the right shoulder was offered to the patient. A CT scan of her right upper extremity showed asymmetric atrophy involving the musculature of the right rotator cuff, including the subscapularis, supraspinatus and infraspinatus muscles as well as the right deltoid muscle. Increased lytic destruction involving the inferior part of the right glenoid was observed, with a tumor extending through the posterior cortex at the spinoglenoid notch. The patient underwent cryoablation of the right shoulder, which resulted in partial relief of the pain. Three months after embolization of the left hepatic artery, CT scans of the abdomen with and without contrast were repeated, which showed metastases in the medial left hepatic lobe and the posterior right hepatic lobe. The patient underwent embolization of right hepatic artery, including the cystic artery. Tumor activity in this case was resistant to treatment, requiring multiple episodes of local modality treatments with HAE. The patient also developed a soft-tissue mass on the left posterior chest wall about 2cm?cm in size. An excisional biopsy of the mass showed a metastatic, poorly differentiated neuroendocrinetumor. Unfortunately, despite systemic chemotherapy, repeated HAE and cryoablation of the right shoulder, the pain in the patient's right shoulder remained to a certain extent. She had no systemic symptoms Capivasertib of carcinoid syndrome, such as diarrhea, flushing, cardiac arrhythmia and shortness of breath, throughout the disease course. She eventually died as a result of liver failure.Discussion Carcinoid tumors are neuroendocrine tumors derived from enterochromaffin cells, also called Kulchitsky cells. Neuroendocrine cells are distributed throughout the whole body, have a similar histological appearance upon diagnosis and can release many neurosecretory granules, such as serotonin, gastrin, somatostatin and substance P. The capacity to secrete a variety of neuropeptides from enterochromaffin cells triggers the symptoms. Depending on the location of the primary carcinoid tumor with or without metastases, PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/7500280 symptoms of carcinoid tumors can vary. Although a majority of carcinoid tumors have indolen.