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Disbalances in the adaptive and humoral immune system may cause IgG4-related disease. This rare disease can affect multiple organ systems, including the retroperitoneum. Retroperitoneal fibrosis can result in postrenal obstruction with accompanied renal failure and/or pain. By means of two case presentations we want to draw attention to this rare disease entity and share our experiences regarding favorable treatment responses with rituximab after unsuccessful treatment with prednisolone. [ABSTRACT FROM AUTHOR]

Ewing's sarcoma (ES)/primitive neuroectodermal tumors (PNETs) are a rare group of tumors commonly arising from bones, uncommonly from soft tissues, and rarely from abdomen. The aim of the study was to analyze the outcome (recurrence-free survival[RFS]), patient characteristics, role of FDG-PET (fluorodeoxyglucose positron emission tomography) computerized scan, chemotherapy and radiation, and prognostic factors. We retrospectively studied patients diagnosed with abdominal ES/PNET and treated surgically between June 2005 and November 2019. Ten patients were included in the study, with a median age of 36.5 years (19–46 years). The median follow-up was 25 months (3–178 months). The site of origin was the retroperitoneum, small bowel, and abdominal wall in six, two, and two patients, respectively. 70% of patients were treated with induction chemotherapy. R0 resection was achieved in 90% of patients. With chemotherapy, there was significant reduction in tumor size (p = 0.034) with non-significant reduction in SUV max (p = 0.31). The 1- and 2-year RFS were 88.90% and 76.20%, respectively. Pathological peritoneal metastasis and ability to achieve R0 resection were prognostic factors affecting RFS. These patients must be offered multimodality treatment. Induction chemotherapy significantly reduces the tumor size. Pathological peritoneal metastasis and ability to achieving R0 resection significantly affect survival. [ABSTRACT FROM AUTHOR]

Although laparoscopy continues to be the gold standard in the diagnosis of deep endometriosis, non-invasive imaging methods are important for an adequate staging of the disease, as they may determine the site, size, and severity of the lesions and thus contribute to planning the surgical treatment better. An observational study was carried out between April 2008 and June 2009 during which time nine consecutive patients underwent preoperative PET scan examination for clinical suspicion of deep endometriosis. PET scans provide a functional assessment of cellular activity; but in our study, it did not exhibit consistent results. [ABSTRACT FROM AUTHOR]

Huntington disease (HD) mutation increases gain-of-toxic functions contributing to glutamate-mediated excitotoxicity. Riluzole interferes with glutamatergic neurotransmission, thereby reducing excitotoxicity, enhancing neurite formation in damaged motoneurons and increasing serum concentrations of BDNF, a brain cortex neurotrophin protecting striatal neurons from degeneration. We investigated metabolic and volumetric differences in distinct brain areas between 11 riluzole-treated and 12 placebo-treated patients by MRI and 18F-fluoro-2-deoxy- d-glucose (FDG) PET scanning, according to fully automated protocols. We also investigated the influence of riluzole on peripheral growth factor blood levels. Placebo-treated patients showed significantly greater proportional volume loss of grey matter and decrease in metabolic FDG uptake than patients treated with riluzole in all cortical areas ( p<0.05). The decreased rate of metabolic FDG uptake correlated with worsening clinical scores in placebo-treated patients, compared to those who were treated with riluzole. The progressive decrease in metabolic FDG uptake observed in the frontal, parietal and occipital cortex correlated linearly with the severity of motor scores calculated by Unified Huntington Disease Rating Scale (UHDRS-I) in placebo-treated patients. Similarly, the rate of metabolic changes in the frontal and temporal areas of the brain cortex correlated linearly with worsening behavioural scores calculated by UHDRS-III in the placebo-treated patients. Finally, BDNF and transforming growth factor beta-1 serum levels were significantly higher in patients treated with riluzole. The linear correlation between decreased metabolic FDG uptake and worsening clinical scores in the placebo-treated patients suggests that FDG-PET may be a valuable procedure to assess brain markers of HD. [ABSTRACT FROM AUTHOR]

We previously reported a high incidence of primary thyroid cancer in fluorodeoxyglucose positron-emission tomogram (FDG-PET)-detected incidental thyroid abnormalities. The aim of our study was to determine if these FDG-PET-detected thyroid malignancies represent a more-aggressive variant of primary thyroid carcinoma. All patients that underwent operative intervention for FDG-PET-detected incidental thyroid abnormalities were identified (June 2003 to April 2006). Patients with a diagnosis of primary thyroid carcinoma on final histopathology were included in the study. The patient demographics and histopathological findings were analyzed to identify adverse prognostic features. In 11,500 patients, 17,250 FDG-PET scans were performed; 377 of these patients (3.2% of patients and 2.1% of FDG-PET scans) had findings positive for thyroid abnormality. Of the 32 patients that underwent operative intervention, 22 patients with a final diagnosis of primary thyroid malignancy were included in the study. A greater number of patients [12 patients, (54%)] were noted to harbor poor prognostic variants of primary thyroid carcinoma on final histopathology [tall-cell variant: 11 patients (50%) and poorly differentiated thyroid carcinoma: 1 patient (4%)]. Extra-thyroidal extension (ETE) was noted in the majority of patients [14 patients (63%)]. In patients with tall cell variant on final histopathology, the rate of ETE was even higher [10 patients (90%)]. Thyroid malignancies incidentally detected on FDG-PET scan harbor a high rate of unfavorable prognostic features and may represent a more-aggressive variant of primary thyroid carcinoma. These patients need to be subjected to further investigation with a view to possible operative intervention. [ABSTRACT FROM AUTHOR]

Fluoro-2-deoxy- d-glucose positron emission tomography (FDG-PET) scanning is useful in evaluating suspicious lesions of the lung. Our patient was a 65-year-old woman with a 45-pack-year smoking history who was referred for further evaluation because of a 3 cm × 3 cm solid lung nodule on computed tomography scan of the chest. FDG-PET scan revealed a standard uptake value of 3.2 suggestive of malignancy. The histology of the lung nodule was consistent with lipoid pneumonia, a benign condition frequently associated with inadvertent aspiration or inhalation of oily substances. [ABSTRACT FROM AUTHOR]

Metastatic disease, from the pancreas, involving the stomach is an unusual clinical event. Local recurrence, liver metastases, and peritoneal spread are the most common recurrent patterns after curative resection of pancreatic cancer. We report a patient who suffered from gastric metastasis secondary to pancreatic adenocarcinoma 1 year after pancreatectomy. A 49-year-old woman underwent distal pancreatectomy with intraoperative radiation therapy for cancer of the body of the pancreas in October 2002. The histological diagnosis was well-differentiated adenocarcinoma of the pancreas, stage IIB; T1N1M0. Multiple liver metastases were detected on computed tomography (CT) in March 2003. Combination chemotherapy of 5-fluorouracil hepatic arterial continuous infusion and systemic gemcitabine administration led to the disappearance of the liver metastases on CT in September 2003. One month later, she complained of epigastric pain and underwent gastric endoscopy, which revealed a submucosal tumor in the fornix posterior wall. Histological diagnosis of the biopsy specimen was well-differentiated adenocarcinoma, and immunohistochemical studies, using anti-cytokeratin 7 and -20 monoclonal antibodies, were compatible with gastric metastasis from pancreatic carcinoma. A F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) scan revealed a high-uptake lesion, which coincided with the gastric tumor. No other abnormal uptake could be found. Histopatholoical examination of the resected specimen revealed submucosal growth of the metastatic cancer (well-differentiated adenocarcinoma). [ABSTRACT FROM AUTHOR]