Faculty of Medicine

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    Item type:Publication,
    Clinical Characteristics and Outcomes of Patients with Lung Cancer and Venous Thromboembolism
    (2018)
    Ruiz-Artacho P,
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    Trujillo-Santos J,
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    López-Jiménez L,
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    Font C,
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    Díaz-Pedroche MDC,
    Background The natural history of patients with lung cancer and venous thromboembolism (VTE) has not been consistently evaluated. Methods We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to assess the clinical characteristics, time course, and outcomes during anticoagulation of lung cancer patients with acute, symptomatic VTE. Results As of May 2017, a total of 1,725 patients were recruited: 1,208 (70%) presented with pulmonary embolism (PE) and 517 with deep vein thrombosis (DVT). Overall, 865 patients (50%) were diagnosed with cancer <3 months before, 1,270 (74%) had metastases, and 1,250 (72%) had no additional risk factors for VTE. During anticoagulation (median, 93 days), 166 patients had symptomatic VTE recurrences (recurrent DVT: 86, PE: 80), 63 had major bleeding (intracranial 11), and 870 died. The recurrence rate was twofold higher than the major bleeding rate during the first month, and over threefold higher beyond the first month. Fifty-seven patients died of PE and 15 died of bleeding. Most fatal PEs (84%) and most fatal bleeds (67%) occurred within the first month of therapy. Nine patients with fatal PE (16%) died within the first 24 hours. Of 72 patients dying of PE or bleeding, 15 (21%) had no metastases and 29 (40%) had the VTE shortly after surgery or immobility. Conclusion Active surveillance on early signs and/or symptoms of VTE in patients with recently diagnosed lung cancer and prescription of prophylaxis in those undergoing surgery or during periods of immobilization might likely help prevent VTE better, detect it earlier, and treat it more efficiently.
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    Coexistence of Paget disease and lung cancer - importance of patient management
    (Discover STM Publishing Ltd., 2022)
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    Stefanovski Todorova, Dusica
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    Background: The coexistence of metabolic bone disease, such as Paget disease (PD) and malignant tumor is frequently described in patients with breast, prostate, lung, lymphoproliferative, colorectal, and renal neoplasms. Indeed, when evaluating cancer patients, there may be diagnostic dilemma of interpreting some changes in bone involvement, whether they are malignant or metabolic changes, since some radiological features of metabolic bone disease can mimic those of bone metastases. Case Presentation: We report a case of 55-year-old male patient, with diagnosed lung adenocarcinoma, referred to the Nuclear Medicine Department for a bone scintigraphy (BS), for evaluation of presented bone metastasis. The Single photon emission computed tomography (SPECT)/computer tomography (CT) scan revealed intensive metabolic accumulation of the radiotracer in cervical vertebra C7, and thoracic vertebra Th1, Th6, Th11, Th12, as well as lumbar vertebra L4, L5, left sacroiliac joint, both iliac and pubic bones and left proximal femur. The FDG PET/CT showed diffuse, but mildly increased uptake in Тh6, Тh11, L4, L5 and pelvic bones (SUV max = 3.3). The CT revealed destruction of Th11 body with compression fracture. Diagnosis of PD was made based on the findings of BS and PET/CT and further confirmed on bone biopsy and the patient was started with bisphosphonate therapy. Conclusion: BS and SPECT/CT are of great importance in accurate detection of incidental PD in patients with lung cancer.