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Pancoast Tumor

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41. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

of the interleukin (IL) 1, IL-6, and tumor necrosis factor (TNF) signaling pathways. Study of the adaptive immune response demonstrated that both proinflammatory and regulatory T cells can be found in the circulation in the first week after fever onset. Expansion of the regulatory T-cell population after IVIG administration is associated with cessation of fever and clinical improvement. The self-limited nature of the disease coupled with a low rate of recurrence suggests emergence of T- and B-cell memory

2017 American Heart Association

42. Imaging Program Guidelines: Pediatric Imaging

is present: ? Non-accidental injury (NAI) ? Trauma associated with any of the following features: ? Altered mental status ? Change in behavior ? Vomiting ? Loss of consciousness ? History of high risk MVA or other mechanism of injury ? Scalp hematoma if less than 2 years of age ? Evidence of basilar skull fracture Note: This indication does not apply to patients with bleeding diathesis or intracranial shunts. Tumor (benign or malignant) ? Diagnosis of suspected tumor when supported by the clinical (...) presentation ? Management (including perioperative evaluation) of established tumor when imaging is required to direct treatment ? Surveillance of established tumorCT Head – Pediatrics | Copyright © 2017. AIM Specialty Health. All Rights Reserved. 10 Common Diagnostic Indications Neurologic Signs & Symptoms This section contains indications for Bell’s palsy, headache, mental status change, syncope, vertigo/dizziness, and visual disturbance. Advanced imaging based on nonspecific signs or symptoms is subject

2017 AIM Specialty Health

45. CRACKCast E043 – Spinal Injuries

Trauma to base of neck Pancoast tumor, Thoracic aneurysm Sympathectomy 12) For what C-spine injuries is CT-A indicated to rule out vascular injury C1-C3 # Any vertebral body fracture Transverse foramen fracture Facet sub/dislocation Ligamentous injury This likely varies on a per institution basis 13) Are steroids indicated for C-spine injuries? Highly controversial – Cochrane review says yes, almost all other sources (guidelines and surveys) say no. Talk to your surgeon. Common dose is 30mg/kg IV

2016 CandiEM

46. Plexopathy

, there are no Current Procedural Terminology (CPT) codes to correspond to the brachial or lumbar plexus directly. In the February 2001 ACR Bulletin (coding questions and answers), the consensus of the Economics Committee on Coding & Nomenclature was that “the choice of the appropriate CPT code for an MRI study of the brachial plexus depends significantly on the clinical indications. For example, an MRI of the chest, focusing on the brachial plexus, is most commonly used in cases of apical lung cancers (Pancoast (...) tumors), 1 Principal Author and Panel Chair, UC San Diego Health, San Diego, California. 2 Vanderbilt University Medical Center, Nashville, Tennessee. 3 Chesapeake Medical Imaging, Annapolis, Maryland. 4 UK Healthcare Spine and Total Joint Service, Lexington, Kentucky, American Academy of Orthopaedic Surgeons. 5 Le Bonheur Children’s Hospital, University of Tennessee Health Science Center, Memphis, Tennessee. 6 Mayo Clinic, Rochester, Minnesota. 7 North Shore- Long Island Jewish Hospital, Hofstra

2016 American College of Radiology

47. Non-Small Cell Lung Cancer Treatment (PDQ®): Patient Version

and improve the quality of life. Chemotherapy and radiation therapy followed by with an , such as durvalumab. A clinical trial of new combinations of treatments. For more information about for and symptoms including cough, shortness of breath, and chest pain, see the summary on . of the superior sulcus, often called , begins in the upper part of the and spreads to nearby such as the , large , and . Treatment of Pancoast tumors may include the following: Radiation therapy alone. Surgery. Chemotherapy (...) . The antibody is usually linked to a substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer. Certain factors affect prognosis (chance of recovery) and treatment options. The (chance of ) and treatment options depend on the following: The stage of the cancer (the size of the tumor and whether it is in the lung only or has spread to other places in the body). The type of lung cancer. Whether the cancer

2018 PDQ - NCI's Comprehensive Cancer Database

48. Non-Small Cell Lung Cancer Treatment (PDQ®): Health Professional Version

tumors, the rate was 1.8% per year for nonpulmonary second cancers and 1.6% per year for new lung cancers.[ ] Other studies have reported even higher risks of second tumors in long-term survivors, including rates of 10% for second lung cancers and 20% for all second cancers.[ ] Because of the persistent risk of developing second lung cancers in former smokers, various chemoprevention strategies have been evaluated in randomized control trials. None of the phase III trials using the agents beta (...) for diagnosis and subclassification, but most lung tumors can be classified by light microscopic criteria. (Refer to the section of this summary for more information on tests and procedures used for staging.) Molecular Features The identification of mutations in lung cancer has led to the development of molecularly targeted therapy to improve the survival of subsets of patients with metastatic disease.[ ] In particular, subsets of adenocarcinoma now can be defined by specific mutations in genes encoding

2018 PDQ - NCI's Comprehensive Cancer Database

49. A Study to Determine Safety of Durvalumab After Sequential Chemo Radiation in Patients With Unresectable Stage III Non-Small Cell Lung Cancer

) treatment Secondary Outcome Measures : Median Progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as assessed by the Investigator [ Time Frame: From the first date of treatment until the date of objective disease progression or death (up to maximum 24 months) ] To assess the efficacy of Durvalumab (MEDI4736) treatment in terms of PFS. PFS will be calculated using Kaplan-Meier product limit methods. PFS at 12 months (PFS12) [ Time Frame: From (...) -advanced NSCLC whose disease has progressed following platinum-based sCRT. Participants who have disease considered for surgical treatment as part of their care plan, such as Pancoast or superior sulcus tumours. Mixed small-cell lung cancer and NSCLC histology. History of allogeneic organ transplantation. Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [eg, colitis or Crohn's disease], diverticulitis [with the exception of diverticulosis], systemic

2018 Clinical Trials

50. Non-Small Cell Lung Cancer Treatment (PDQ®): Health Professional Version

tumors, the rate was 1.8% per year for nonpulmonary second cancers and 1.6% per year for new lung cancers.[ ] Other studies have reported even higher risks of second tumors in long-term survivors, including rates of 10% for second lung cancers and 20% for all second cancers.[ ] Because of the persistent risk of developing second lung cancers in former smokers, various chemoprevention strategies have been evaluated in randomized control trials. None of the phase III trials using the agents beta (...) for diagnosis and subclassification, but most lung tumors can be classified by light microscopic criteria. (Refer to the section of this summary for more information on tests and procedures used for staging.) Molecular Features The identification of mutations in lung cancer has led to the development of molecularly targeted therapy to improve the survival of subsets of patients with metastatic disease.[ ] In particular, subsets of adenocarcinoma now can be defined by specific mutations in genes encoding

2016 PDQ - NCI's Comprehensive Cancer Database

51. Non-Small Cell Lung Cancer Treatment (PDQ®): Patient Version

and improve the quality of life. Chemotherapy and radiation therapy followed by with an , such as durvalumab. A clinical trial of new combinations of treatments. For more information about for and symptoms including cough, shortness of breath, and chest pain, see the summary on . of the superior sulcus, often called , begins in the upper part of the and spreads to nearby such as the , large , and . Treatment of Pancoast tumors may include the following: Radiation therapy alone. Surgery. Chemotherapy (...) of tissue. The antibody is usually linked to a substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer. Certain factors affect prognosis (chance of recovery) and treatment options. The (chance of ) and treatment options depend on the following: The stage of the cancer (the size of the tumor and whether it is in the lung only or has spread to other places in the body). The type of lung cancer. Whether

2016 PDQ - NCI's Comprehensive Cancer Database

52. A novel muscle-sparing high thoracotomy for upper thoracic spine resection and reconstruction. (PubMed)

with invasion of the T5 and T6 vertebral bodies, two malignant fibrous histiocytomas causing thoracic cord compression, a metastatic T6 lesion of unknown primary with associated cord compression; and a Pancoast tumor. All patients seen at 6 months had full symmetric shoulder range of motion postoperatively.The described muscle-sparing, high thoracotomy approach provides excellent exposure of the ventral cervicothoracic and upper thoracic spine without the morbidity associated with the transection (...) cervicothoracic and upper thoracic spine lesions.A novel muscle-sparing, high thoracotomy approach is described, utilizing a midline posterior incision with lateral extension from the lateral decubitus position. Five patients are presented to illustrate the application of this technique in thoracic tumors with intimate spinal involvement.The muscle-sparing, high thoracotomy approach afforded gross total resection and spinal reconstruction in five consecutive patients, including stage IV lung carcinoma

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2017 European Spine Journal

53. Locally-advanced stage III non-small-cell lung cancer (NSCLC)

chemoradiotherapy), it is at least possible that high procedure volume may play a comparably important role. Concerning radiotherapy,it has been shown that,within clinicaltrials where quality assurance of radiotherapy has been implemented, protocol deviations of radiotherapy delivery were associated with increased risks of treatment failure and overall mortality [19]. Another example is Pancoast tumour resection (sulcus superior tumours) after combined chemoradiotherapy; this should preferably be carried out (...) as part of an intermediate group (2) or de?nitely unresectable (3). In the intermediate group, resec- tion is deemed to have an underlying increased risk of an in- complete resection. Here, typically tumours of the superior sulcus (Pancoast) and speci?ccentrallylocatedtumours(T3/ T4 involvement) can be identi?ed [13, 32]. Evaluating and predicting these parameters upfront is key for adequate plan- ning of the de?nitive local treatment without treatment inter- ruptions (either surgery, a neoadjuvant

2015 European Society for Medical Oncology

54. Non-Invasive Clinical Staging of Bronchogenic Carcinoma

is staged using the eighth edition of the tumor-node-metastasis (TNM) criteria of the American Joint Committee on Cancer, developed under the auspices of the International Association for the Study of Lung Cancer and informed by database analysis of nearly 95,000 patients primarily from Europe and Asia [4]. Clinical noninvasive staging by radiologic imaging is the first step in determining the appropriate management for patients with lung cancer. T Descriptor The T descriptor is based on size (...) and location of the primary tumor, the presence or absence of atelectasis or postobstructive pneumonitis, and the degree of invasion into adjacent structures exhibited by the primary tumor [5,6]. ? T0 describes no evidence of a primary lung tumor [5]. ? Tis describes carcinoma in situ, either squamous cell or adenocarcinoma [5]. ? T1 comprises tumors =3 cm in greatest dimension, subdivided into four categories: (1) T1a(mi) is minimally invasive lepidic-predominant adenocarcinomas =3 cm with =0.5 cm

2013 American College of Radiology

55. Risk Factors of Medistinal Metastasis in Endoscopic Staging of Lung Cancer

topics: related topics: (AHRQ) related information: Groups and Cohorts Go to Outcome Measures Go to Primary Outcome Measures : Relative risk of risk factors for mediastinal metastasis [ Time Frame: When confirmative diagnosis are available in all subjects ;3 years ] risk factors; CT staging (N0-3), PET staging (N0-3), tumor location(central or peripheral), tumor size and histologic types of lung cancer. Secondary Outcome Measures : Diagnostic values of endoscopic staging [ Time Frame: When (...) suspected non-small cell lung cancer (NSCLC) Potentially operable Exclusion Criteria: M1 disease Inoperable T4 disease Mediastinal infiltration or extranodal invasion of the mediastinal lymph node visible on chest CT Confirmed supraclavicular lymph node metastasis Pancoast tumours T1 ground glass opacity nodule (with solid part 1

2016 Clinical Trials

56. Horner's Syndrome after Scalene Block and Carotid Dissection. (PubMed)

BE AWARE OF THIS?: The pathologies underlying Horner's syndrome are exceedingly diverse. Although classic teaching often focuses on neoplastic causes, and more specifically Pancoast tumors, neoplasms are discovered only in a small minority of Horner's syndrome cases. Other etiologies include trauma, cervical artery dissection, and infarction. With a better understanding of the pertinent anatomy and array of possible etiologies, emergency physicians may have more success in identifying and treating

2016 Journal of Emergency Medicine

57. Lung Cancer

spread (40% at diagnosis) Nerve injury Recurrent laryngeal nerve paralysis Weak cough Phrenic nerve lesion Left diaphragm elevated lesion Presents as Horner Syndrome ( , myosis, facial anhidrosis) Associated with Pancoast's tumor ( and muscle wasting C8-T3) wall invasion Malignant Decreased breath sounds Malignant Decreased heart sounds Cardiomegaly on Esophageal invasion or obstruction Facial swelling Upper extremity edema Plethora VIII. Presentations: Extrathoracic spread (33% at diagnosis) Long (...) , Bronchogenic Carcinoma From Related Chapters II. Epidemiology Lung Cancer is the top U.S. cause of cancer death Lung Cancer accounts for 27% of all U.S. cancer deaths Lung Cancer accounts for 33% of overall mortality in heavy smokers Exceeds deaths from combination of 3 cancers : 200,000 in U.S. (2010) Mortality: 160,000 in U.S. (2010) Age at diagnosis: 68 to 70 years old on average III. Pathophysiology Hematogenous seeding occurs at 1-2 mm Earliest detection of Tumor by CT : 2 mm Tumor 1 cm size shed 3

2018 FP Notebook

58. Shoulder Pain

Shoulder Pain Cardiac (e.g. , ) Left arm, or Neck, lower jaw, and interscapular Pulmonary (Carcinoma, , or abscess) Pancoast (Apical Tumor of superior sulcus lung) Other mediastinal, aorta, esophageal causes VII. Causes: Malignant Sources of Referred Shoulder Pain Bone Metastases ( most common) metastases (less common) Ribs, spine, and (more common) XRay and bone scans have high Periosteal bone formation Results in cranial or spinal impingement Usually minimal or no symptoms Increased pain Think tous

2018 FP Notebook

60. Thoracic Outlet Syndrome - Neurogenic

to an infiltrative process or space-occupying mass (e.g. Pancoast tumor of the lung apex). B. ELECTRODIAGNOSTIC STUDIES (EDS) EDS abnormalities are required to objectively confirm the diagnosis of nTOS. Given the uncertainties in diagnostic assessment of nTOS, EDS should be obtained as soon as the diagnosis is considered. EDS may help gauge the severity of injury. 8-10 Importantly, EDS can help exclude conditions that may mimic nTOS, such as ulnar nerve entrapment or cervical radiculopathy. 11 EDS evidence (...) poor specificity for nTOS, and there is no substantial evidence that ASM can reliably confirm the diagnosis of nTOS. Therefore, ASM blocks conducted as a diagnostic tool for nTOS will not be authorized. X-rays of the chest may be useful to evaluate the possibility of an infiltrative process or space-occupying mass (e.g. Pancoast tumor of the lung apex) compressing the brachial plexus. V. TREATMENT Non-surgical therapy may be considered for cases in which a provisional diagnosis of nTOS has been

2010 Washington State Department of Labor and Industries

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