Antitumor and immunotherapeutic effects of activated invasive T lymphoma cells that display short-term interleukin 1alpha expression.
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Expression of cytokines in malignant cells represents a novel approach for therapeutic treatment of tumors. Previously, we demonstrated the immunostimulatory effectiveness of interleukin 1alpha (IL-1alpha) gene transfer in experimental fibrosarcoma tumors. Here, we report the antitumor and immunotherapeutic effects of short-term expression of IL-1alpha by malignant T lymphoma cells. Activation in culture of T lymphoma cells with lipopolysaccharide-stimulated macrophages induces the expression of IL-1alpha. The short-term expression of IL-1alpha persists in the malignant T cells for a few days (approximately 3-6 days) after termination of the in vitro activation procedure and, thus, has the potential to stimulate antitumor immune responses in vivo. As an experimental tumor model, we used the RO1 invasive T lymphoma cell line. Upon i.v. inoculation, these cells invade the vertebral column and compress the spinal cord, resulting in hind leg paralysis and death of the mice. Activated RO1 cells, induced to express IL-1alpha in a short-term manner, manifested reduced tumorigenicity: approximately 75% of the mice injected with activated RO1 cells remained tumor free. IL-1 was shown to be essential for the eradication of activated T lymphoma cells because injection of activated RO1 cells together with IL-1-specific inhibitors, i.e., the IL-1 receptor antagonist or the M 20 IL-1 inhibitor, reversed reduced tumorigenicity patterns and led to progressive tumor growth and death of the mice. Furthermore, activated RO1 cells could serve as a treatment by intervening in the growth of violent RO1 cells after tumor take. Thus, when activated RO1 cells were injected 6 or 9 days after the inoculation of violent cells, mortality was significantly reduced. IL-1alpha, in its unique membrane-associated form, in addition to its cytosolic and secreted forms, may represent a focused adjuvant for potentiating antitumor immune responses at low levels of expression, below those that are toxic to the host. Further assessment of the immunotherapeutic potential of short-term expression of IL-1alpha in activated tumor cells may allow its improved application in the treatment of malignancies. (+info)
Cervical epidural lipoblastomatosis: changing MR appearance after chemotherapy.
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Lipoblastomatosis is a locally infiltrative tumor of embryonic fat. We describe the MR appearance of cervical lipoblastomatosis with epidural extension. The initial MR study showed features of a soft-tissue mass; a subsequent MR examination, performed after chemotherapy, depicted the lesion as a typical lipoma of high signal intensity on T1-weighted images and of intermediate signal on T2-weighted sequences. (+info)
Treatment strategies and results in spinal vascular malformations.
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We report the treatment strategies and results of 70 patients with spinal vascular malformations. Forty-six had dural arteriovenous fistulas, 12 spinal cavernous angiomas, nine intramedullary angiomas, and three intradural arteriovenous fistulas. The diagnosis was established for cavernomas by magnetic resonance images only and in the other cases by selective spinal angiography in patients whose neurological deficits, myelograms or magnetic resonance images suggested the presence of a spinal vascular malformation. All patients had symptomatic vascular malformations and were treated microsurgically. Intramedullary angiomas were operated when embolization seemed too dangerous or impossible and when they had a contact to the dorsal or lateral surface of the spinal cord. All but one were completely resected. In one angioma a small ventral residual fistula area was left. Complete obliteration of all fistulas was achieved. The cavernomas were primarily resected. Apart from one postoperative permanent deterioration with a paresis of the left arm in a patient with an intramedullary angioma, 16 cases presented only a transitory worsening of their neurological status after surgery. The long-term outcome of all these patients was good. Five patients had to be operated on again: three patients showed difficult localizations of dural fistulas which were still visible in the postoperative angiograms, one patient suffered a spinal epidural hematoma, and another patient showed a cerebrospinal fluid accumulation. We conclude that spinal dural arteriovenous fistulas, small intradural fistulas, spinal cavernomas, and symptomatic spinal angiomas with contact to the lateral or dorsal surface can be treated microsurgically with low perioperative morbidity. (+info)
Pathologic odontoid fracture and benign fibrous histiocytoma of bone.
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We present the case of a 44-year-old female patient, who sustained an odontoid fracture after a minor trauma (uncomplicated fall). The radiologic evaluation revealed a skeletal tumor of the second cervical vertebra together with a fracture line at the base of the odontoid process of the axis. The patient underwent surgery, the tumor was resected and the odontoid was stabilised using an autologous cortico-cancellous bone graft and a halo fixator. Histologic examination revealed benign fibrous histiocytoma, which is reported to be a very rare skeletal tumor. (+info)
A staff dialogue on caring for a cancer patient who commits suicide: psychosocial issues faced by patients, their families, and caregivers.
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Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The Center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum during which caregivers discuss a specific cancer patient, reflect on the important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from their fellow staff members. The case presented was of a 31-year-old man who developed adenocarcinoma of the lung with painful bone metastases. His tumor was unresponsive to treatment and he subsequently committed suicide by shooting himself. The verbatim and subsequent discussion raised a number of issues. Staff were devastated by the violent way that he ended his life. They questioned whether more could have been done to prevent this outcome, yet acknowledged that it mirrored the way he had lived, and were able to discuss the values by which we live and die. Some, but not all, felt that the patient had the right to choose how and when to end his life. (+info)
Cervical epidural rhabdomyosarcoma with a leukemia-like presentation in an aged patient--case report.
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A 77-year-old female presented with rhabdomyosarcoma manifesting as leukemia-like indications. Neuroimagings detected cervical and paravertebral masses. Immunohistochemical study of the surgically excised mass lesion from the cervical spine established the correct diagnosis. This leukemia-like presentation of rhabdomyosarcoma requires a multidisciplinary approach to establish the correct diagnosis and treatment. (+info)
Hypervascular spinal tumors: influence of the embolization technique on perioperative hemorrhage.
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BACKGROUND AND PURPOSE: Corporectomy is an effective treatment for vertebral metastases; however, massive perioperative hemorrhage is often associated with this procedure. We compared preoperative particle, particle-coil, and coil embolizations of hypervascular spinal tumors prior to vertebral body replacement to determine which prevented perioperative hemorrhage most effectively. METHODS: The vertebral tumors of 59 patients were embolized prior to corporectomy. In 26 cases, only coils were used for the proximal occlusion of feeding segmental arteries. Twenty-four patients received a combination of polyvinyl alcohol (PVA) particles and coils, and nine tumors were embolized with particles alone. We compared intraoperative blood loss between the three groups and 10 other patients who did not undergo embolization prior to corporectomy. RESULTS: Estimation of intraoperative hemorrhage showed a median value of 4350 mL in patients without embolization, 2650 mL in cases of coil embolization, 1850 mL in cases of particle-coil embolization, and 1800 mL in cases of particle embolization. The difference between unembolized patients and those who underwent coil embolization was not statistically significant. Particle and particle-coil embolizations showed very similar results, and reduced hemorrhage significantly as compared to unembolized and proximal coil occlusion cases. Residual bleeding came from the venous system and the neighborhood of the embolized region. CONCLUSION: Particle embolization prior to corporectomy can reduce perioperative hemorrhage. The additional benefit of proximal coil occlusion of arterial feeders is questionable. (+info)
Acute spinal cord compression due to intraspinal bleeding from a vertebral hemangioma: two case-reports.
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Vertebral hemangiomas can cause acute spinal cord compression either after a minor trauma or during the last 3 months of pregnancy. Failure to recognize the lesion can lead to potentially serious treatment delays. An emergency MRI scan usually establishes the diagnosis of vertebral hemangioma responsible for spinal cord compression requiring laminectomy. We report two cases showing that posterior fixation should be considered: in our experience it prevents vertebral collapse during the interval preceding secondary vertebroplasty, which, if performed, provides highly significant pain relief. (+info)