Arterial occlusion of the internal iliac artery was successful in the relief of pain due to primary and secondary neoplasms of the bony pelvis in 8 of 9 patients. These included 3 giant cell tumors, l aneurysmal bone cyst, l recurrent chondrosarcoma, 3 metastatic renal cell carcinoma and 1 metastatic clear cell sarcoma. Calcification of the margin of the lesion occurred in 3 of 4 primary neoplasms after infarction. The transcatheter arterial occlusion was accomplished utilizing Gelfoam and stainless steel coils. Although most patients experienced pain and fever for several days following the procedure, no permanent sequelae or complications were encountered.
The radiographic features of 22 cases of histologically proven periosteal chondroma are analyzed in detail. The typical tumor consisted in an area of outer cortex remodeling (scalloping) involving the metaphyseal lesion of a long bone with slightly overhanging edges and a small amount of cartilage calcified matrix adjacent to the scalloping. The presence of a visible soft tissue mass was uncommon, present in only third of the cases. The radiographic differential diagnosis is analyzed in detail and illustrated.
A total of 49 patients were treated using intraarterial cis-platinum infusions at a dose of 100 mg/m2. The patients were separated into three groups. There were 13 patients with metastatic tumors, 10 with recurrent malignant gliomas, and 22 patients with high-grade gliomas who received intraarterial cis-platinum as part of an adjuvant program. In addition, four nongliomatous primary brain tumors were treated in this fashion. Cis-platinum was filtered immediately prior to intraarterial infusion using a 0.22-micron filter. Response to treatment was evaluated by follow-up CAT scans and neurologic examinations. There were three complete and eight partial responses in metastatic tumors, and eight partial responses in recurrent gliomas. The median survival was 19 weeks for patients with metastatic disease, and 16 weeks for patients with recurrent gliomas. Those high-grade glioma patients who received intraarterial cis-platinum as adjuvant chemotherapy along with CCNU and radiation therapy had a projected median survival of 91+ weeks. Toxicity from intraarterial cis-platinum following drug filtration was markedly reduced when compared with previous reports. Only five patients experiencing visual or central nervous system toxicity utilizing filtered cis-platinum and no radiographic or histopathologic evidence of central nervous system toxicity was observed. Bilateral deafness was observed following vertebral artery infusion in both patients treated in this manner and thus vertebral artery infusions should be avoided. Systemic toxicity was mild. Intracarotid infusion is a safe, well-tolerated delivery system for filtered cis-platinum with a high response rate for patients with both metastatic and primary malignant brain tumors.
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