Background: The term "paraneoplastic syndrome" describes a clinically apparent disease associated with a malignant neoplasm, which is not a direct consequence of invasive tumor growth. Acral ischemia and digital necrosis of multiple fingertips have been occasionally described as a paraneoplastic syndrome. However, the exact mechanisms of this phenomenon are still not adequately known.
Case Report: This paper describes a 72-year-old male patient with severe acral ischemia and multiple necroses on several fingertips. Symptoms evolved under palliative chemotherapy with gemcitabine for inoperable metachronous squamous cell carcinoma of the tonsil following a history of two simultaneous carcinomas of the alveolar crest. Digital ischemia was combined with severe pain, similar to Raynaud's syndrome, which required therapeutic intervention. The treatment objective is to improve perfusion and simultaneously reduce pain. A combination of iloprost, an analog of prostacyclin (50 micrograms intravenous Ilomedin once daily), and a CT-guided thoracic sympathectomy achieved a continuous positive effect on the intensity of acral ischemia and alleviated the pain.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10006-002-0399-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
12. Vascular pain: Ischemic pain in the extremities and Raynaud's syndrome.
Pain Pract
September 2024
Anesthesiology and Pain Medicine, Rijnstate Ziekenhuis, Elst, The Netherlands.
Article Synopsis
- Peripheral artery diseases (PAD) and Raynaud's syndrome significantly impact patients' quality of life, potentially leading to severe complications like gangrene and tissue necrosis, necessitating extensive medical care.
- This review examines the latest literature on diagnosing and treating these conditions, focusing on interventional pain treatments and their effectiveness in managing symptoms and improving outcomes.
- In PAD, early conservative treatments are essential, while interventional therapies may be needed as the disease progresses; however, there is varying evidence regarding the effectiveness of certain procedures like sympathectomy.
Relationship Between Symmetrical Peripheral Gangrene Patients and Using Vasopressors in the Intensive Care Unit.
Cureus
April 2024
College of Medicine, King Faisal University, Al-Hofuf, SAU.
Symmetrical peripheral gangrene (SPG) is a rare yet severe condition characterized by peripheral ischemic lesions without significant vascular occlusion. Its clinical presentation includes peripheral cyanosis, mottling, and symmetrical ischemia of distal limbs, often progressing to gangrene. Recent years have seen a rise in SPG cases, with mortality rates ranging from 40% to 90%.
View Article and Find Full Text PDFDigital Gangrene as a Paraneoplastic Manifestation of Peripheral T-cell Lymphoma Not Otherwise Specified Type.
J Assoc Physicians India
January 2024
Consultant Hematopathologist, GKNM Hospital, Coimbatore, Tamil Nadu, India.
Background: Peripheral T cell lymphoma (PTCL), not otherwise specified (NOS) is a heterogenous group of predominantly nodal T cell lymphomas that generally presents with lymphadenopathy with or without extra nodal involvement. Acral vascular syndrome clinically presents as digital ischemia with Raynaud's phenomenon and acral cyanosis. Although, this condition is commonly associated with connective tissue disorder, smoking and vasculitis, its association with lymphoid malignancy is very rare.
View Article and Find Full Text PDFLimb Ischemic Necrosis Secondary to Microvascular Thrombosis: A Brief Historical Review.
Semin Thromb Hemost
July 2024
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
Ischemic limb injury can be broadly classified into arterial (absent pulses) and venous/microvascular (detectable pulses); the latter can be divided into two overlapping disorders-venous limb gangrene (VLG) and symmetrical peripheral gangrene (SPG). Both VLG and SPG feature predominant acral (distal) extremity ischemic necrosis, although in some instances, concomitant nonacral ischemia/skin necrosis occurs. Historically, for coagulopathic disorders with prominent nonacral ischemic necrosis, clinician-scientists implicated depletion of natural anticoagulants, especially involving the protein C (PC) system.
View Article and Find Full Text PDFCalciphylaxis, beware the ophthalmic mimic: A case series.
Clin Nephrol Case Stud
December 2023
Department of Ophthalmology, and.
Article Synopsis
- This text discusses two rare cases of calciphylaxis that showed eye-related issues without typical skin symptoms, aiming to increase awareness of the condition.
- The cases include a 76-year-old woman with kidney failure and anterior ischemic optic neuropathy (AION), and a 44-year-old man on dialysis with AION and central retinal artery occlusion (CRAO).
- It emphasizes the importance of recognizing calciphylaxis in kidney patients with eye problems, and suggests a temporal artery biopsy for accurate diagnosis to prevent unnecessary treatments like steroids.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!