Browsing by Author "Mehta, Hiren J"
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Item Concomitant tracheal and subcutaneous glomus tumor: Case report and review of the literature(2015) Fernández-Bussy, Sebastián; Labarca, Gonzalo; Rodriguez, Macarena; Mehta, Hiren J; Jantz, MichaelGlomus tumors are unusual and generally benign neoplasms mainly found in subungeal areas. We describe a case of concomitant subcutaneous and tracheal glomus tumor that underwent successful endoscopic resection. A 48-year old male with a left forearm subcutaneous mass presented with hemoptysis. A chest CT scan demonstrated a polypoid tracheal lesion. He underwent a bronchoscopic resection. A biopsy revealed a glomus tumor, which was the same type of neoplasm that was found on the forearm biopsy. Glomus tumors are rarely found in the respiratory tract. Only 49 cases have been described. The majority of the glomus tumors arise from the lower posterior tracheal wall with no extraluminal extension. Bronchoscopic resection has been successfully used. Glomus tumors should be included in the differential diagnosis of tracheobronchial lesions. Bronchoscopic resection and adjuvant radiotherapy are valid treatment options. This is the first report of concomitant subcutaneous and tracheal glomus tumor, as well as the first reported airway glomus tumor, in Latin America. As part of this study, we also perform a literature review.Item Restoration of Patency to Central Airways Occluded by Malignant Endobronchial Tumors Using Intratumoral Injection of Cisplatin(2015) Mehta, Hiren J; Begnaud, Abbie; Penley, Andrea M; Wynne, John; Malhotra, Paras; Fernández-Bussy, Sebastián; Cope, Jessica; Shuster, Jonathan J; Jantz, Michael ARationale: Malignant airway obstruction is commonly found in patients with lung cancer and is associated with significant morbidity and mortality. Relieving malignant obstruction may improve symptoms, quality of life, and life expectancy. Objectives: The objective of this study was to analyze our experience with bronchoscopic endobronchial intratumoral injection of cisplatin for malignant airway obstruction. Methods: We conducted a retrospective analysis of patients with malignant airway obstruction treated with bronchoscopic intratumoral injection of cisplatin. Patient characteristics, histology, degree of airway obstruction, procedural methods, treatment cycles, performance status, and therapeutic outcomes were evaluated. Tumor response was analyzed based on bronchoscopic measurements performed on completion the of final treatment session. Adverse events and overall survival were abstracted. Measurements and Main Results: Between January 2009 and September 2014, 22 patients (10 men, 12 women; mean age 6 SD, 64.4 6 9.5 yr) were treated with one to four injections of 40 mg of cisplatin mixed in 40 ml of 0.9% NaCl. Treatments were completed 1 week apart. The primary etiologies of airway obstruction included squamous cell carcinoma (n = 11), adenocarcinoma (n = 6), small cell carcinoma (n = 2), large cell undifferentiated carcinoma (n = 1), and metastatic endobronchial cancer (n = 2). Twenty-one of 22 patients were evaluable for response. The majority of patients (15/21, 71.4%) responded to therapy, defined as greater than 50% relative reduction in obstruction from baseline. Treatment response was obtained regardless of tumor histology, concurrent systemic therapy, number of treatment cycles administered, performance status, or use of additional ablative interventions. Responders had significantly improved overall survival as compared with nonresponders, although the difference was small. Severe treatment-related side effects or complications were not observed. Conclusions: Subject to the limitations of a single-center retrospective study and a subjective primary outcome measure, we have demonstrated the feasibility of improving the patency of central airways that are largely or completely occluded by endobronchial malignant tumor using intraluminal injection of cisplatin. Additional longer-term, larger-scale safety and comparative effectiveness studies of this palliative treatment modality are warranted.