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Case Reports in Oncology

Shoji Yomo, Keiji Tsutsumi, Takehiro Yako, Hiromasa Sato, Takao Hashimoto, Kazuhiro Oguchi
Intravascular lymphoma (IVL) is a rare and clinically devastating subtype of extranodal diffuse large B-cell lymphoma with a distinct presentation. Diagnostic difficulty derives from marked variability in clinical presentations and nonspecific laboratory and radiological findings, especially when central nervous system (CNS) symptoms are the only manifestation. Establishing the diagnosis premortem thus remains a major challenge. We describe a 70-year-old male with CNS IVL. He presented with acute onset of neurocognitive impairments...
May 2018: Case Reports in Oncology
Bowen Li, Zhenhua Zhu, Shunhua Long, Fei Li, Xuan Zhu, Wangdi Liao
We report a case of acute myeloid leukemia with myelodysplasia-related changes in a patient with Crohn's disease. The patient was diagnosed with Crohn's disease at the age of 47 years and was treated with the tumor necrosis factor α inhibitors adalimumab and infliximab, and a short course of azathioprine. Four years later, the patient developed acute myeloid leukemia with myelodysplasia that involved mainly erythropoiesis. Crohn's disease is associated with an increased risk of cancers including hematological malignancies...
May 2018: Case Reports in Oncology
Rouslan Kotchetkov, Robert El-Maraghi, Leena Narsinghani
A 74-year-old male with a history of chronic lymphocytic leukemia (CLL) previously treated with fludarabine/cyclophosphamide/rituximab (FCR) 5 years ago, presented with progressive fatigue, mucocutaneous bleeding, and cytopenias (hemoglobin 51 g/L, platelets 8.0 × 109 /L, lymphocytes 0.4 × 109 /L). He had normal respiratory findings, and no lymphadenopathy or hepatosplenomegaly. Further workup revealed a small spiculated lung nodule and multiple sclerotic bony lesions. Due to bleeding/profound thrombocytopenia, lung biopsy was not feasible...
May 2018: Case Reports in Oncology
Susumu Noguchi, Hiroaki Kawachi, Hiroshi Yoshida, Akari Fukao, Satoshi Terashita, Tatsuyoshi Ikeue, Sadao Horikawa, Takakazu Sugita
Nivolumab, an anti-PD-1 antibody, inhibits binding between PD-1 and PD-1 ligand and activates antigen-specific T cells that have become unresponsive to cancer cells. Although it is recommended as a second-line therapy in gene mutation-negative non-small-cell lung cancer, interstitial pneumonia is a well-known side effect of the drug; however, granulomatous lesions have rarely been reported. We describe the case of an 81-year-old male with cT1aN2M1b stage IV pleomorphic carcinoma of the left upper lobe of the lung...
May 2018: Case Reports in Oncology
Nikolaos Mitsimponas, Evangelia Klouva, Dimitrios Tryfonopoulos, Anastasios Grivas, Stamatina Demiri, George Koumakis, Panagiotis Gouveris
Aromatase inhibitors (AIs) are a commonly used antihormonal therapy in the treatment of breast cancer in postmenopausal women, specifically in the treatment of hormone receptor-positive breast cancer. AI-associated tendinopathy and muscle tendon rupture is exceedingly rare. Until now, only one case with AI-associated severe tendinopathy has been reported in the medical literature, and there are no recorded cases of AI-associated muscle tendon rapture. We report three cases of postmenopausal women with hormone receptor-positive breast cancer, who experienced tendinopathy or muscle tendon rupture under antihormonal treatment with letrozole...
May 2018: Case Reports in Oncology
Yoshito Nishimura, Miho Yasuda, Kazuki Ocho, Masaya Iwamuro, Osamu Yamasaki, Takehiro Tanaka, Fumio Otsuka
Immune checkpoint inhibitors such as ipilimumab, a cytotoxic T-lymphocyte-associated antigen-4 inhibitor, have been widely used for advanced malignancies. As these inhibitors improve antitumor immunity via T-cell modulation, immune-mediated adverse events associated with T-cell activation, such as colitis, might occur. Herein, we describe a 75-year-old Japanese woman with metastatic malignant melanoma who developed hemorrhagic gastritis after ipilimumab treatment. There was no macroscopic or clinical improvement of gastritis after proton pump inhibitor treatment...
May 2018: Case Reports in Oncology
Rita Dorantes-Heredia, Daniel Motola-Kuba, Jose Manuel Ruiz-Morales, Wallace Rafael A Muñoz-Castañeda, Carolina Vega-Ochoa, Roberto De la Peña
We report a case of metastases from a cancer of unknown primary whose primary site could not be identified during the appropriate pretreatment evaluation. The patient was a 58-year-old woman with a history of passive smoking and with no history of cancer in the family. Her current condition started with asthenia, adynamia, and pallor, followed by palpitations. An abdominopelvic computed tomography (CT) scan was performed, showing multiple osteolytic lesions distributed in all bone structures and axillary adenopathy on the left side...
May 2018: Case Reports in Oncology
Eshan Patel, P Kancharla, B K Surapaneni, K Hennrick, M Goldfinger, M Kalavar
Epithelioid hemangioendothelioma (EHE) is a rare low-grade vascular neoplasm that is characterized as intermediate between benign hemangioma and high-grade angiosarcoma affecting 1 in 1,000,000 people worldwide. It has been described throughout the body with lung, liver, skin, and bone being the most frequent sites. Primary EHE of the spine has been reported in 56 cases so far with no correlation of age and sex. Our case highlights a rare clinical presentation, etiopathogenesis, diagnosis, and treatment of EHE of the spine with metastasis to the right atrium...
May 2018: Case Reports in Oncology
Heidi Egloff, Kelley M Kidwell, Anne Schott
Purpose: T-DM1 is an antibody drug conjugate with proven efficacy in metastatic breast cancer for progressive disease refractory to trastuzumab. Drug-induced pneumonitis is a rare serious potential adverse effect. The purpose of this review was to estimate the incidence of pulmonary toxicity at our institution. Methods: A retrospective analysis of electronic medical record data inclusive of all women and men aged 18 years and older treated with T-DM1 at out institution was undertaken...
May 2018: Case Reports in Oncology
Anastasie M Dunn-Pirio, Suma Shah, Christopher Eckstein
Recently, immune checkpoint inhibitors have revolutionized cancer care by enhancing anti-tumor immunity. However, by virtue of stimulating the immune system, they can lead to immune-related adverse events (irAEs). Neurologic irAEs are uncommon but are becoming increasingly recognized and can be quite serious or even fatal. Furthermore, central nervous system (CNS) manifestations may be difficult to distinguish from CNS metastases, posing management challenges. Here, we describe a patient who developed exacerbation of sarcoidosis leading to CNS involvement following dual checkpoint blockade with nivolumab and ipilimumab for metastatic melanoma and review the relevant literature...
May 2018: Case Reports in Oncology
Yuko Yoshida-Ichikawa, Masahiko Tanabe, Emi Tokuda, Hideo Shimizu, Yoshiya Horimoto, Kayo Miura, Mitsue Saito
Everolimus is an effective treatment for advanced and/or metastatic breast cancer, especially in hormone receptor-positive cases. However, adverse events have prevented considerable numbers of clinicians from using this drug. Herein, we reviewed our clinical experiences and endeavored to identify patients in whom the benefits of everolimus treatment would outweigh these adverse events. If measures were available to prevent or minimize adverse effects prior to treatment, everolimus would be a more widely applicable drug...
May 2018: Case Reports in Oncology
Hassan Alyami, Talal Alsofyani, Mohammed Bu Bshait, Emad Mohammed Al-Osail
Background: Primary thyroid lymphoma (PTL) is a rare disease, accounting for 5% of all thyroid malignancies. Diffuse B-cell lymphoma (DBCL) is the most common type of PTL. The diagnosis of PTL depends on biopsy results, and its management depends on the histological type. Case Presentation: A 66-year-old female complained of a huge neck mass on the right side that had started growing 3 months previously and was associated with compressive and B symptoms. She had undergone left hemithyroidectomy 20 years previously...
May 2018: Case Reports in Oncology
António José Loureiro da Silva, Carolina Carvalho, Miguel Jacobetty, João Freitas, Ruben Fonseca, Paulo F Tavares, Helena Garcia, Margarida Borrego, José M Casanova
Here, we present the case of a 78-year-old male patient with undifferentiated spindle cell sarcoma on the posteromedial surface of the right leg who experienced a long-lasting progression-free survival. Due to an underlying cardiac disease, the patient was not suitable for anthracyclines. In September 2015, he received first-line chemotherapy with trabectedin (Yondelis®) at the approved dosage and regimen - concomitant with external radiotherapy (RT). After the first 9 cycles of trabectedin plus RT given in the neoadjuvant setting, the patient underwent surgical resection...
May 2018: Case Reports in Oncology
Julia V M Huiskes, Mariël E Keemers-Gels, Jan Fabré, Luc J A Strobbe
Local recurrence after an autologous breast reconstruction is uncommon. We describe 2 patients with local recurrence 3 and 9 years, respectively, after mastectomy with DIEAP (deep inferior epigastric artery perforator) flap breast reconstruction. Patients generally present with a palpable mass, pain, or other visible abnormalities. Various imaging techniques are helpful, always completed by biopsy to characterize the tumour. A repeated sentinel node procedure can be useful in staging. The treatment of the local recurrence needs to be determined in a multidisciplinary team consultation...
May 2018: Case Reports in Oncology
Mohammad Muhsin Chisti, Daniel Steven Sanders
Fusion of b2a2 is the most common BCR/ABL rearrangement in CML; however, absent a2 exons are very rare. We describe a case with Philadelphia-positive chronic myeloid leukemia (CML) with a very rare b3a3 (e14a3) BCR/ABL junction. To our knowledge, only 15 such cases of CML have previously been reported. These uncommon transcripts may be under-reported, since RT-PCR-based assays may fail to detect these fusions due to the location of the primers and probes used. We are reporting this case for the first time which presented with MTHFR mutation and significant thrombocytosis...
May 2018: Case Reports in Oncology
Abdallah Al Farai, Lénaïg Mescam, Valeria De Luca, Audrey Monneur, Delphine Perrot, Jerome Guiramand, Jean-Robert Delpero, François Bertucci
Hepatic hemangioma is the most common benign hepatic tumor, and most of them are small in size and asymptomatic. Giant hepatic hemangiomas are uncommon, but pedunculated giant hemangiomas are even rarer and often difficult to diagnose because of their exophytic development. We report here on a 48-year-old man with a symptomatic pedunculated giant hepatic hemangioma and hepatic angiomatosis, mimicking a gastric gastrointestinal stromal tumor with liver metastases. The preoperative diagnosis was suspected on imaging including CT scan and MRI...
May 2018: Case Reports in Oncology
Mohammed U Al Homsi, Mai Mostafa, Khaled Fahim
Avelumab is indicated for the management of Merkel cell carcinoma, a rare and aggressive neuroendocrine skin cancer. Its regulatory approval followed the positive outcome of a Phase 2 trial on 88 patients with stage IV disease, which excluded patients with immunodeficiency due to HIV, a risk factor for this cancer type. We report a positive and sustained response to avelumab in an HIV-positive patient with stage IV Merkel cell carcinoma refractory to previous chemotherapy (cisplatin/etoposide) and radiotherapy...
May 2018: Case Reports in Oncology
Satoko Arai, Tomohiko Hara, Yoshiyuki Matsui, Keiichi Koido, Hironobu Hashimoto, Yasuo Shinoda, Motokiyo Komiyama, Hiroyuki Fujimoto, Hiroyuki Terakado
Objective: Compared with standard treatment, a modified tri-weekly MVAC (methotrexate, doxorubicin, vinblastine, and cisplatin) treatment regimen with a high cisplatin dose intensity shows good efficacy and lower toxicity. Thus, we retrospectively investigated the tolerability and efficacy of a modified tri-weekly MVAC neoadjuvant regimen. Methods: We analyzed 25 patients with locally advanced bladder cancer medicated by a modified tri-weekly MVAC neoadjuvant regimen that omits treatment on days 15 and 22...
May 2018: Case Reports in Oncology
Masatsune Shibutani, Kiyoshi Maeda, Hisashi Nagahara, Tatsunari Fukuoka, Yasuhito Iseki, Shinji Matsutani, En Wang, Kosei Hirakawa, Masaichi Ohira
As a result of recent major advances in chemotherapy for metastatic colorectal cancer, the prognosis for patients with metastatic colorectal cancer has improved. However, elderly patients often cannot receive intensive therapy. There are still many problems to solve regarding treatment for elderly patients with metastatic colorectal cancer. We herein report a case of complete response of pulmonary metastases from rectal cancer to tegafur-uracil (UFT)/leucovorin (LV) + bevacizumab (Bmab) in an elderly patient...
May 2018: Case Reports in Oncology
Tomoyuki Nakano, Kaoru Tamura, Yoji Tanaka, Motoki Inaji, Shihori Hayashi, Daisuke Kobayashi, Tadashi Nariai, Jun Toyohara, Kenji Ishii, Taketoshi Maehara
Recently developed molecular targeted therapies such as bevacizumab (BEV; Avastin) therapy have therapeutic efficacy for glioblastoma. However, it is difficult to distinguish between a tumor response and nonenhancing tumor progression with conventional magnetic resonance imaging (MRI) after BEV administration. Here we present a recurrent glioblastoma case in which 11 C-methionine positron emission tomography (MET-PET) provided useful information for detecting tumor recurrence after complete remission, as assessed by the Response Assessment in Neuro-Oncology criteria...
May 2018: Case Reports in Oncology
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