The lung is a common site for metastasis of malignant tumors from other organs. The metastatic cascade is a complex process that involves a series of events. Tumors can spread to the lung through hematogenous or lymphangitic routes. In the absence of extrathoracic metastasis, complete resection is associated with increased survival, regardless of histology. With appropriate patient selection, life expectancy is often improved with pulmonary metastasectomy. Stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) are 2 approaches that have been increasingly reported for pulmonary tumors. Although these new therapies have yet to match the long-term success rates of surgical therapy, the techniques demonstrate good results in treating high-risk surgical candidates with metastatic lesions to the lungs that would otherwise be considered with resection. This review will focus on the role of local therapy in oligometastasis that arise in the lung.
Life Expectancy ; Lung ; Metastasectomy ; Neoplasm Metastasis ; Patient Selection

Protein-losing enteropathy (PLE) is a syndrome characterized by excessive gastrointestinal protein loss, resulting in hypoproteinemia and edema. A variety of benign and malignant conditions can be associated with PLE and acute leukemia is a very rare cause of PLE. We report a case of PLE associated with acute lymphoblastic leukemia. A 27-year-old man was admitted due to watery diarrhea, epigastric pain and bilateral leg edema. Laboratory findings showed hypoproteinemia and polycythemia. The diagnosis of PLE and acute lymphoblastic leukemia were confirmed on the measurement of fecal alpha1-antitrypsin clearance and bone marrow examination. After systemic chemotherapy and autologous stem cell transplantation, his clinical symptoms and abnormal laboratory findings were gradually improved.
Adult ; Bone Marrow Cells/pathology ; Endoscopy, Gastrointestinal ; Humans ; Magnetic Resonance Imaging ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*diagnosis/genetics ; Protein-Losing Enteropathies/complications/*diagnosis ; Thoracic Vertebrae/radiography ; Tomography, X-Ray Computed ; Translocation, Genetic ; alpha 1-Antitrypsin/analysis

A central nervous system (CNS) relapse is a rare but mostly fatal complication in patients with diffuse large B cell lymphoma (DLBCL). CNS involvement can occur as an isolated event or can be combined with progression of systemic disease. There are limited data on treatment outcomes of patients with DLBCL and secondary CNS involvement. We report the clinical data, treatments, and outcomes of two DLBCL patients with isolated CNS relapses involving the brain parenchyma. Isolated CNS disease involving the brain parenchyma may be potentially treatable as the initial relapse site after complete remission from systemic treatment.
Brain* ; Central Nervous System ; Central Nervous System Diseases ; Humans ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Recurrence*

PURPOSE: We have examined the expression of c-erbB-2 oncogene in sera and tissues of non-small cell lung cancer patients. MATERIALS AND METHODS: Serum levels of c-erbB-2 protein were measured by an enzyme im munoassay in 55 patients with non-small cell lung cancer. Sera from patients with surgical therapy were evaluated again after surgery. Immunohistochemical staining was performed in 47 of these tumors. RESULTS: Elevated levels (> or =45 U/mL, control mean 2SD) were observed in 15% of 55 non-small cell lung cancer patients, as compared with none of control subjects (p<0.05). The incidence of elevated level was higher in the adenocarcinoma than squamous cell carcinoma (22% vs 4%, p<0.01). The serum levels of c-erbB-2 protein decreased significantly after surgical tumor ablation (p<0.01). Tissue overexpression was obtained in 23/47 cases (49%). The incidence of c-erbB-2 overexpression was higher in the adenocarcinoma (73% vs 29%, p<0.005). No relationship was found between c-erbB-2 protein expression in serum and tumor tissue and clinicopathologic feature. Elevated serum c-erbB-2 levels predicted tissue overexpression with sensitivity 30% and specificity 96%. There was relationship between serum level and expression in tumor tissue of c-erbB-2 protein. CONCLUSION: Serum and tissue levels of c-erbB-2 correlate in patients with non-small cell carcinoma. Serum c-erbB-2 protein may be a useful indicator of tumor burden in patients with non-small cell lung cancer.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Incidence ; Oncogenes ; Receptor, erbB-2* ; Sensitivity and Specificity ; Tumor Burden

Renal cell carcinoma is well known for its tendency to metastasize early to the lung, bone, and liver, but skeletal muscle is an extremely unusual site of metastasis. We report here on an unusual case with numerous skeletal muscle metastases in the posterior abdominal wall and buttock 2 years after radical nephrectomy for renal cell carcinoma.
Abdominal Wall ; Buttocks ; Carcinoma, Renal Cell* ; Liver ; Lung ; Muscle, Skeletal* ; Neoplasm Metastasis* ; Nephrectomy*

The idiopathic hypereosinophilic syndrome consists of peripheral blood eosinophilia of 1500/mm3 or more without a known cause, plus signs and symptoms of organ eosinophilia. The prognosis of HES without treatment is poor. However, about one third of the patients with this syndrome may respond to corticosteroid thrapy. Morever, the majority of the remainder may have a favorable response to hydroxyurea. We present here a case of hypereosinophilic syndrome without any identifiable causes, involving bone marrow, liver, lungs and cervical lymph node. We tried corticosteroid as a treatment but it showed no response. However the hydroxyurea showed good response.
Bone Marrow ; Eosinophilia ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome ; Liver ; Lung ; Lymph Nodes ; Prognosis

BACKGROUND: The possibility of cord blood transplantation in adults was limited by the amount of cord blood that could be collected. Cord blood transplantation after ex vivo expansion with cytokines have already been tried in adults. Amifostine is a phosphorylated aminothiol that affords broad cytoprotection from the myelosuppressive effects of antineoplastic agents. The purposes of this study were to investigate expansion of progenitor and myeloid cells after ex vivo culture of mononuclear cells (MNCs) in umbilical cord blood with growth factor and characterize hematopoietic activities of amifostine. METHODS: MNCs were cultured and ex vivo expanded into myeloid progenitors by using hematopoietic growth factors (IL-1beta, IL-3, IL-6, G-CSF, GM-CSF, SCF, EPO) which are known to stimulate differentiation and proliferation of myeloid progenitors. MNCs exposed to the appropriate amount of amifostine for 15 min were cultured in semisolid media and harvested at 24h intervals, and then apoptosis was assessed by propidium iodide staining. RESULTS: Myeloid colonies were successfully produced from MNCs. Maximal expansion was obtained with the combination of IL-3+SCF+G-CSF+GM-CSF. SCF was thought to be the most important growth factor for expansion of myeloid progenitor. Pretreatment with amifostine for 15 min stimulated formation of hematopoietic colonies at clinically relevant concentrations ranging from 1 to 100 micrometer. Increase in colony number compare to control were comparable after pretreatment with amifostine (10micrometer), and CFU-GEMM and BFU-E were highly responsive. Further enhancement of colony was not observed after prolonging the duration of pre- incubation exposure to 1, 8 and 24 hours. Amifostine enhanced IL-1 and IL-3 induced formation of CFU-GEMM and BFU-E. Incubation of MNCs with amifostine in suspension culture increased recovery of secondary colonies. Treatment with amifostine retarded cell loss and apoptosis, and promoted cell survival at 24, 48 and 72 hours in cytokine-deficient medium. CONCLUSION: Cord blood MNCs can be successfully expanded into myeloid progenitors by using hematopoietic growth factors. This investigation extend the previously recognized hematologic effects of amifostine, and indicate that in addition to its cytoprotective properties, amifostine is a stimulant of hematopoietic progenitor growth.
Adult ; Amifostine* ; Antineoplastic Agents ; Apoptosis ; Cell Survival ; Cytokines ; Cytoprotection ; Erythroid Precursor Cells ; Fetal Blood ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-1 ; Interleukin-3 ; Interleukin-6 ; Myeloid Cells ; Myeloid Progenitor Cells ; Propidium

PURPOSE: The authors conducted a multicenter study to evaluate the efficacy and safety of combination chemotherapy with Padexol(R) and cisplatin for treating patients with advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: From November 2003 to April 2005, 42 chemo-naive patients with advanced NSCLC were enrolled into this study from 4 hospitals. The treatment consisted of Padexol(R) 175 mg/m2 as a 3-hr infusion, and this was followed by cisplatin 75 mg/m2 administered as an intravenous infusion with standard premedication. The treatment was repeated every 3 weeks. RESULTS: Among the 42 patients (pts), 33 pts were evaluable for response. On the per protocol analysis, 1 patient (pt) (3.0%) achieved complete response (CR), 17 pts (51.5%) achieved partial response (PR), 6 pts (18.2%) achieved stable disease (SD), and 9 pts (27.3%) progressed; therefore, the overall response rate was 54.6% (95% CI: 37.6~71.5%). On the intention-to-treat analysis, 1 pt (2.4%) achieved CR, 18 pts (42.9%) achieved PR, 11 pts (26.2%) achieved SD, and 9 pts (21.4%) progressed; therefore, the overall response rate was 45.2% (95% CI: 30.2~60.3%). The response, as evaluated by the investigators, was independently reviewed by 2 external radiologists and it was as follows; 13 PR (43.3%), 14 SD (46.7%) and 3 progressive disease (10%). The median duration of response was 5.9 months. The median follow-up duration was 10.3 months (range: 1.3 to 22.1 months). The median time to progression was 5.8 months (95% CI: 4.7 to 7.4 months). The median survival time on the intention-to-treat analysis was 10.5 months (95% CI: 8.1 to 18.8 months). The most common grade 3 or 4 hematologic toxicities were neutropenia (26/180 cycles, 14.4%), anemia (7/180 cycles, 3.9%) and febrile neutropenia (2/180 cycles, 1.1%). The most frequent grade 3 or 4 non-hematologic toxicities were nausea (14/42 patients, 14.3%), anorexia (3/42 patients, 7.1%) and myalgia (3/42 patients, 7.1%). CONCLUSION: The authors observed that Padexol(R) was as good as the other paclitaxel (Taxol(R) or Genexol(R)) formulations when combined with cisplatin for treating patients with advanced NSCLC.
Anemia ; Anorexia ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination ; Febrile Neutropenia ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Myalgia ; Nausea ; Neutropenia ; Paclitaxel ; Premedication ; Research Personnel

Extramedullary plasmacytoma (EMP) is a rare disease that occurs in 3% to 5% of patients with plasma cell disorder. It occurs most commonly in the upper respiratory tract and the oral cavity. Very few EMP cases have been reported in the central nervous system (CNS). We report herein an unusual case of EMP in the nasal cavity that recurred in the CNS without systemic involvement. A 67-year-old man visited our hospital due to a month-long bout with exophthalmos. He was diagnosed with EMP in the nasal cavity, paranasal sinus, and orbital cavity. He received radiotherapy to which he had complete responses. After 2 years, he visited our hospital because of a month-long headache. He was diagnosed with EMP recurrence in the CNS via brain magnetic resonance imaging and cerebrospinal fluid analysis. He was treated with whole brain radiotherapy and intrathecal chemotherapy with methotrexate, but he expired due to pneumonia.
Aged ; Brain ; Central Nervous System* ; Cerebrospinal Fluid ; Drug Therapy ; Exophthalmos ; Headache ; Humans ; Magnetic Resonance Imaging ; Methotrexate ; Mouth ; Nasal Cavity ; Orbit ; Plasma Cells ; Plasmacytoma* ; Pneumonia ; Radiotherapy ; Rare Diseases ; Recurrence ; Respiratory System

Primary retroperitoneal mucinous cystadenocarcinoma is a rare tumor. Only about 30 such cases have been reported in the worldwide literature, and a few Korean cases have been reported. The pathogenesis is not clear, and coelomic metaplasia of the retroperitoneal mesothelium has gained wide support. There is no consensus on the appropriate treatment, but surgical exploration is needed for the diagnosis and treatment, and adjuvant chemotherapy may be recommended following complete surgical excision. The long-term prognosis has not been established. We report here on a 32-year-old woman who was diagnosed as having a retroperitoneal mucinous cystadenocarcinoma with mural nodules of sarcomatoid change. Tumor excision and adjuvant chemotherapy were done and the patient is doing well without any evidence of recurrence at 42 months postoperatively.
Adult ; Cystadenocarcinoma, Mucinous/*diagnosis/pathology/surgery ; Female ; Humans ; Retroperitoneal Neoplasms/*diagnosis/pathology/surgery