Treatment of Metastatic Pheochromocytoma With Streptozocin

Feldman, Jerome M.

doi:10.1001/archinte.1983.00350090181033

Cited by 33 publications

(4 citation statements)

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“…10 The role of streptozocin in the treatment of pheochromocytoma is controversial, with only anecdotal responses reported. 9 Newer chemotherapeutic agents have, to date, proved relatively inactive in neuroendocrine tumors. High-dose paclitaxel, administered with granulocytecolony-stimulating factor, was evaluated in 24 patients with metastatic carcinoid or islet cell tumors.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Patients with pheochromocytoma, a less common neuroendocrine tumor, have been treated with streptozocin and DTIC-based chemotherapy regimens, also with only limited success. 9,10 Recent attempts to develop novel treatment regimens with less associated toxicity have been relatively unsuccessful. Phase II studies of paclitaxel and docetaxel, for example, have shown little activity against neuroendocrine tumors.…”

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confidence: 99%

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A Phase II trial of gemcitabine for metastatic neuroendocrine tumors

Kulke

Kim

Clark

et al. 2004

Cancer

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BACKGROUND. Treatment with traditional cytotoxic chemotherapy regimens containing streptozocin or dacarbazine has resulted in only marginal benefit for patients with metastatic neuroendocrine tumors. The use of these regimens has been further limited by their potential toxicity. Gemcitabine is generally well tolerated and possesses demonstrated activity against a wide range of malignancies. The authors assessed the efficacy of gemcitabine in the treatment of patients with metastatic neuroendocrine tumors. METHODS. Eighteen patients with metastatic neuroendocrine tumors were treated with gemcitabine administered on a standard weekly schedule. Patients were followed for evidence of toxicity, response, and survival. RESULTS. Gemcitabine was well tolerated. However, no radiologic or biochemical responses were observed. Although the majority of patients (65%) experienced disease stabilization as their best response to therapy, the overall median survival duration was only 11.5 months. CONCLUSIONS. The minimal activity of gemcitabine highlighted the need for novel treatment approaches. Cancer 2004;101:934-9.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

A Phase II trial of gemcitabine for metastatic neuroendocrine tumors

Kulke

Kim

Clark

et al. 2004

Cancer

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“…The only significant change in physical findings was mild elevated blood pressure of 130/100 and 140/100 mm Hg supine and standing, respectively. Analysis of 24-hr urine and plasma by previously described methods revealed an increased level of catecholamines and their metabolites, with norepinephrine appearing to predominate [2] (Table I). Computerized tomography of the abdomen revealed a 6.0 by 4.5 cm left adrenal mass and scintiscanning with the NE analogue [ '311]-meta-iodobenzylguanidine confirmed that it was a pheochromocytoma (Fig.…”

Section: Case Reportmentioning

confidence: 86%

Adult respiratory distress syndrome in a pregnant patient with a pheochromocytoma

Feldman

1985

Journal of Surgical Oncology

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Five weeks after developing spells of shortness of breath, headache, weakness and abdominal pain, a 29-year-old woman, who was in the 36th week of her third pregnancy developed adult respiratory distress syndrome (ARDS). Although the ARDS resolved after a cesarean section, her infant died at birth. Her "spells" continued until a left pheochromocytoma was diagnosed and resected 2 years later. If there are no other known inciting causes of ARDS in a pregnant patient, a pheochromocytoma should be ruled out with appropriate catecholamine determinations.

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“…We also considered the use of streptozocin, because in one instance, a prolonged remission was induced in a patient with a metastatic pheochromocytoma. 7 This potentially toxic and costly treatment is saved for future use for our patient.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Metastatic Pheochromocytoma and Medullary Thyroid Carcinoma (Men II)

et al. 1988

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The association between medullary thyroid carcinoma, pheochromocytoma, and hyperparathyroidism in various combinations has been referred to as multiple endocrine neoplasia type II (MEN II). We report here an unusual patient with a malignant pheochromocytoma and medullary thyroid carcinoma. Case ReportThe patient was a 36-year-old Saudi male living in the desert near Al-Wajhe in the Northern Province who presented to King Faisal Specialist Hospital in March 1984 with a 10-month history of tremor, headache, vomiting, dizziness, anorexia, postprandial epigastric pain, 20-kg weight loss, dysphagia, and hoarse voice. His five brothers and four sisters were reported to be in good health. Specifically, none of them had a history of hypertension or goiter. Numerous attempts to persuade the family to come to our hospital for a study were unsuccessful. The patient was a thin, emaciated bedouin. Serial blood pressure readings in the hospital were recorded between 90/60 and 220/120 mm Hg. During hypertensive crises, he developed a consistent pattern of chest pain, dyspnea, sweating, and sinus tachycardia up to 160 beats per minute. He had a firm goiter with a retrosternal extension and hepatomegaly (7 cm below the right costal margin). The rest of the physical examination was unremarkable.Laboratory investigations yielded the following results: hemoglobin, 115 g/L (normocytic normochromic anemia); leukocyte count, 5.7 10 9 /L; and erythrocyte sedimentation rate, 20 mm/h. Results of chemical analyses of the blood were within normal limits, except for fasting blood glucose level of 8.5 mmol/L. Levels of serum calcium, phosphorus, and alkaline phosphatase were all within normal limits on multiple determinations over a 2-year period.Results of serum hormone tests were as follows: thyroxine, 137.7 nmol/L (normal, 68 to 159.6 nmol/L); free thyroxine index, 41.31 nmol (normal, 16 to 38 nmol); calcitonin, 8300 and 5350 ng/L (normal, 0 to 28.5 ng/L); and carcinoembryonic antigen (CEA), 2450 and 960 nmol/L (normal, 0 to 500 nmol/L). Plasma norepinephrine levels were 33.1 and 4.86 nmol/L (normal, 0.6 to 4.1 nmol/L), and plasma epinephrine, 180 and 315 pmol/L (normal, 0 to 545.8 pmol/L). Diagnostic ImagingA CT scan of the abdomen with contrast enhancement revealed a 12-cm, irregular, low-density mass in the right adrenal gland, poorly delineated from the liver, approaching the right hemidiaphragm, and with an incomplete rim of dense calcification. In the left adrenal gland, a 7-cm, irregular, low-density mass was seen. A slightly low-density mass in the right lobe of the liver measuring 7×3×3 cm was noted caudally and laterally consistent with a metastasis (Figure 1).An abdominal aortogram (Figure 2), with selective injections in the renal arteries (not shown), done at the time of attempted therapeutic embolization of the tumor revealed a vascular mass in the right adrenal bed fed by the right phrenic artery, right middle adrenal arteries, branches of the right renal artery, and from the lumbar arteries. A vascular mass in the left adr...

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Treatment of Metastatic Pheochromocytoma With Streptozocin

Cited by 33 publications

References 10 publications

A Phase II trial of gemcitabine for metastatic neuroendocrine tumors

A Phase II trial of gemcitabine for metastatic neuroendocrine tumors

Adult respiratory distress syndrome in a pregnant patient with a pheochromocytoma

An Unusual Case of Metastatic Pheochromocytoma and Medullary Thyroid Carcinoma (Men II)

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