{"title":"Short-term corticosteroid therapy consecutive to hemodialysis and charcoal hemoperfusion for methotrexate-induced acute kidney injury in an elderly lymphoma patient","authors":"Misato Tane , Hiroki Hosoi , Hideki Kosako , Yukiko Yamano , Takayuki Hiroi , Shogo Murata , Toshiki Mushino , Shin-Ichi Araki , Takashi Sonoki","doi":"10.1016/j.cpccr.2024.100282","DOIUrl":"https://doi.org/10.1016/j.cpccr.2024.100282","url":null,"abstract":"<div><p>Acute kidney injury (AKI) due to delayed methotrexate (MTX) elimination is a severe potential adverse event of high-dose (HD)-MTX treatment. However, no treatment for HD-MTX-induced AKI has been established. In addition, there are no reports of corticosteroids being administered for HD-MTX-induced AKI. Here, we report the case of a 77-year-old male with central nervous system lymphoma, who developed an AKI after the second course of HD-MTX. He underwent charcoal hemoperfusion and hemodialysis immediately after the development of the AKI. He also received short-term corticosteroid therapy due to inflammatory findings and a positive drug-induced lymphocyte stimulation test for MTX. Our case suggests that short-term corticosteroid therapy consecutive to hemodialysis and charcoal hemoperfusion may be useful for AKI induced by delayed MTX elimination even in the elderly.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100282"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266662192400005X/pdfft?md5=080e6d8d893f78355246fce604eb8a27&pid=1-s2.0-S266662192400005X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139714561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joel Rivera-Concepcion , Ying-Chun Lo , Dipesh Uprety , Alex A. Adjei , Vinicius Ernani , Konstantinos Leventakos
{"title":"A challenging case of stage IV EGFR-mutant lung cancer with histologic transformation and multiple resistance mechanisms","authors":"Joel Rivera-Concepcion , Ying-Chun Lo , Dipesh Uprety , Alex A. Adjei , Vinicius Ernani , Konstantinos Leventakos","doi":"10.1016/j.cpccr.2024.100284","DOIUrl":"https://doi.org/10.1016/j.cpccr.2024.100284","url":null,"abstract":"<div><p>This clinical case presents a patient with NSCLC who experienced on-target resistant mutations and tumor cell transformation from adenocarcinoma to large cell neuroendocrine and small cell carcinoma. Our patient was successfully treated with a combination of targeted therapy, immunotherapy and chemotherapy based on genetic and histologic changes that occurred in a period of five years.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100284"},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621924000073/pdfft?md5=0ba2fe24f9c99e760e08461b6d035097&pid=1-s2.0-S2666621924000073-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139733248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deborah van de Wal , Evelyne Roets , Roos F. Bleckman , Jorn Nützinger , Birthe C. Heeres , J. Martijn Kerst , Mahmoud Mohammadi , Anna K.L. Reyners , Ingrid M.E. Desar , Astrid W. Oosten , Neeltje Steeghs , Winette T.A. van der Graaf
{"title":"Treatment dilemmas in patients with gastrointestinal stromal tumors (GIST) who experienced imatinib-induced pneumonitis: A case series","authors":"Deborah van de Wal , Evelyne Roets , Roos F. Bleckman , Jorn Nützinger , Birthe C. Heeres , J. Martijn Kerst , Mahmoud Mohammadi , Anna K.L. Reyners , Ingrid M.E. Desar , Astrid W. Oosten , Neeltje Steeghs , Winette T.A. van der Graaf","doi":"10.1016/j.cpccr.2024.100280","DOIUrl":"https://doi.org/10.1016/j.cpccr.2024.100280","url":null,"abstract":"<div><h3>Introduction</h3><p>Imatinib has led to a phenomenal progress in the treatment of GIST. A rare and lesser-known side effect of imatinib is pneumonitis, an uncommon multicausal interstitial lung disease.</p></div><div><h3>Methods</h3><p>Patients registered within the Dutch GIST Registry (DGR) were reviewed. For the patients identified with an imatinib-induced pneumonitis we reported the time on imatinib to develop pneumonitis, how the pneumonitis was diagnosed, graded and managed, and how the GIST treatment was managed.</p></div><div><h3>Cases</h3><p>Of the 1934 patients registered in the DGR, 1161 patients received imatinib at some point, of which nine patients (0.8 %) were identified with an imatinib-induced pneumonitis. At time of the pneumonitis, patients received a daily imatinib dose of 200–400 mg for a mean duration of 486 days. One patient was able to continue imatinib in a lower dose, in the other eight patients imatinib was interrupted, and six of these patients started prednisolone treatment. After management of the imatinib-induced pneumonitis, four patients stopped imatinib permanently, two patients were rechallenged with imatinib, and two patients started treatment with second-line sunitinib.</p></div><div><h3>Conclusion</h3><p>Imatinib-induced pneumonitis is a rare side effect, which may affect GIST management considerably. After the management of imatinib-induced pneumonitis, clinicians are left with difficult treatment dilemmas.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100280"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621924000036/pdfft?md5=30301d16ab28aaf6cd3f1b1875384bd4&pid=1-s2.0-S2666621924000036-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139714562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Metastatic renal angiosarcoma to the liver with underlying JAK2 mutation","authors":"Ankita Kapoor , Bei Yang , Parikshit Padhi","doi":"10.1016/j.cpccr.2024.100279","DOIUrl":"https://doi.org/10.1016/j.cpccr.2024.100279","url":null,"abstract":"<div><p>Renal angiosarcomas are rare malignancies with approximately 70 published cases and comprise less than 1 % of all kidney tumors. We present an elderly male who was found to have a large 10 cm kidney mass and underwent a left radical nephrectomy. Pathology revealed a renal angiosarcoma and unfortunately 3 months later was found to have metastatic disease in the liver. He was incidentally found to have a JAK2 positive myeloproliferative neoplasm at the same time. Molecular testing on the angiosarcoma revealed a JAK2V617F mutation. He was treated with standard of care chemotherapy; initially with paclitaxel and then anthracyclines. He also received liverdirected therapy with Y90 with stable disease. He unfortunately passed away due to an unrelated illness. Our case highlights a rare type of kidney malignancy and that JAK2V617F is a potential driver mutation in angiosarcomas.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100279"},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621924000024/pdfft?md5=a54179ad5febed679482246a92625d44&pid=1-s2.0-S2666621924000024-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139675420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seyed Matin Malakouti, Mohammad Bagher Menhaj, Amir Abolfazl Suratgar
{"title":"ML: Early Breast Cancer Diagnosis","authors":"Seyed Matin Malakouti, Mohammad Bagher Menhaj, Amir Abolfazl Suratgar","doi":"10.1016/j.cpccr.2024.100278","DOIUrl":"https://doi.org/10.1016/j.cpccr.2024.100278","url":null,"abstract":"<div><p>Breast cancer is the most common malignancy among women worldwide, often characterized by the uncontrolled proliferation of breast cells, leading to the formation of lumps or tumors that can be detected through medical imaging such as X-rays. Distinguishing between benign and malignant tumors presents a significant challenge in the diagnosis of breast cancer.</p><p>In this study, machine learning methods, including Logistic Regression, Gradient Boosting, Ada Boost, Random Forest, and Gaussian NB with Grid Search, were employed to differentiate between healthy individuals and those with malignancies. The results revealed that the Random Forest algorithm exhibited the highest performance in predicting breast cancer, accurately identifying 99 % of both healthy and affected individuals. Additionally, both Gradient Boosting and Ada Boost demonstrated a similar level of accuracy, correctly distinguishing 98 % of healthy and affected individuals.</p><p>Conversely, Gaussian NB performed the least effectively, with an accuracy of 91 % in differentiating between healthy and affected individuals, highlighting its comparatively lower predictive capability for breast cancer.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100278"},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621924000012/pdfft?md5=ceb405394533ced110a3290c7dbc4ff6&pid=1-s2.0-S2666621924000012-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139436532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dr Lucy G Faulkner , Dr Oyeyemi Akala , Dr Meera Chauhan , Dr Sean Dulloo
{"title":"Bilateral optic neuritis attributed to Pembrolizumab: A case report","authors":"Dr Lucy G Faulkner , Dr Oyeyemi Akala , Dr Meera Chauhan , Dr Sean Dulloo","doi":"10.1016/j.cpccr.2023.100271","DOIUrl":"10.1016/j.cpccr.2023.100271","url":null,"abstract":"<div><p>Immunotherapy has revolutionised cancer treatment over the past decade and is now well established in the management of a range of cancer primaries, including non-small cell lung cancer. Pembrolizumab acts as a checkpoint inhibitor through programmed death protein 1 (PD-1) inhibition. However, the use of immune checkpoint inhibitors can be complicated by immune-related adverse events (irAE). Neurological complications are rare but are associated with high morbidity compared to other irAE.</p><p>Here we report a rare case of bilateral optic neuritis following Pembrolizumab in a patient treated for metastatic lung adenocarcinoma. The patient had also received whole brain radiotherapy during the course of the treatment. Symptom onset occurred during maintenance treatment and at twelve months after first commencing systemic anticancer treatment. Fundoscopy demonstrated optic disc pallor with enhancement of the optic nerves and optic chiasm was seen on Magnetic Resonance Imaging. Symptoms were refractory to steroid treatment and resulted in chronic and profound visual impairment.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100271"},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000558/pdfft?md5=0bd26457a6c5f96be440f1b57f7fa468&pid=1-s2.0-S2666621923000558-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139391957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel Francisco Pereira Aleixo , Holly Pederson , Nancy Dalpiaz , Jame Abraham
{"title":"Noninvasive prenatal testing detecting metastatic breast cancer: Case report and literature review","authors":"Gabriel Francisco Pereira Aleixo , Holly Pederson , Nancy Dalpiaz , Jame Abraham","doi":"10.1016/j.cpccr.2023.100277","DOIUrl":"10.1016/j.cpccr.2023.100277","url":null,"abstract":"<div><p>Noninvasive prenatal testing (NIPT) analyzes placental cell-free DNA in maternal blood for genetic abnormalities, especially in pregnant women of advanced maternal age. It is a high-sensitivity and specificity test used for screening fetal chromosome trisomy 13, 18, 21, sex chromosome aneuploidy, and rare fetal chromosome aneuploidy. Rarely there were cases in which it was used to diagnose maternal cancer. We will discuss a case of metastatic breast cancer diagnosed by NIPT and current knowledge on the use of this technology in diagnosing cancer during pregnancy.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100277"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000613/pdfft?md5=7b55634122888285d9962acb319ddb46&pid=1-s2.0-S2666621923000613-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hyunwoo Kwon , Mingjia Li , Jesse D Sheldon , Nicholas Jones , Nicolas Gallastegui Crestani , Zihai Li , Dwight H Owen
{"title":"Case report: Hypereosinophilia in non-small cell lung cancer","authors":"Hyunwoo Kwon , Mingjia Li , Jesse D Sheldon , Nicholas Jones , Nicolas Gallastegui Crestani , Zihai Li , Dwight H Owen","doi":"10.1016/j.cpccr.2023.100275","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100275","url":null,"abstract":"<div><h3>Background</h3><p>Hypereosinophilia, as defined by the absolute eosinophil count ≥ 1,500 cells per microliter, can be a consequence of primary (clonal) hematologic disorders or secondary response to inflammation from allergens, parasitic infections, medications or cancer. Its evaluation requires comprehensive history and physical as well as laboratory studies to identify the underlying cause and assess for evidence of end-organ damage in concern for hypereosinophilia syndrome. Here, we report a rare case of paraneoplastic hypereosinophilia with an absolute eosinophil count exceeding 70,000 cells per microliter in the setting of a newly diagnosed metastatic non-small cell lung cancer.</p></div><div><h3>Case presentation</h3><p>A 60-year-old Caucasian male smoker with past medical history of cerebrovascular accidents and heart failure with reduced ejection fraction presented with acute encephalopathy and later developed multi-system organ failure. Peripheral blood smear and other hematologic studies were not suggestive of clonal hematologic malignancy. Extensive infectious work-up of peripheral blood, lower respiratory tract and cerebrospinal fluid was negative. Review of recent medical record did not identify any potentially causative drugs. Diagnostic thoracentesis of the loculated pleural effusion showed poorly differentiated non-small cell lung cancer, which was deemed as the underlying etiology of his profound hypereosinophilia. His encephalopathy and other signs and symptoms of end organ damage were thought less likely to be directly driven by hypereosinophilia. Progressive critical illness unfortunately precluded disease-directed therapy and his family opted for comfort care to mitigate suffering.</p></div><div><h3>Conclusions</h3><p>Our case report highlights paraneoplastic etiology as an important diagnostic consideration in a patient with unexplained hypereosinophilia. Review of the literature shows that hypereosinophilia in patients with non-small cell lung cancer and other solid malignancies correlates with rapid disease progression and poor prognosis, though the underlying mechanisms remain unclear. Interestingly, case reports of hypereosinophilia in non-small cell lung cancer suggest a male-biased incidence. Investigation of the role of eosinophils in modulating anti-tumor immunity and its sex difference is warranted.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100275"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000595/pdfft?md5=9a5b3dcd9a8d27eeae1abba47671966e&pid=1-s2.0-S2666621923000595-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matteo Mario Carlà , Luca Ausili Cefaro , Gianluca Di Fiore , Giovanni Cuffaro , Carola Culiersi , Teresa Musarra , Gustavo Savino
{"title":"Bilateral orbital metastases from lobular breast carcinoma mimicking an orbital inflammatory process","authors":"Matteo Mario Carlà , Luca Ausili Cefaro , Gianluca Di Fiore , Giovanni Cuffaro , Carola Culiersi , Teresa Musarra , Gustavo Savino","doi":"10.1016/j.cpccr.2023.100274","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100274","url":null,"abstract":"<div><p>We report a case of synchronous bilateral orbital metastases from primary lobular breast cancer with the radiographic imaging features of a diffuse orbital soft tissue inflammatory process. A 77-year-old lady with a history of lobular breast cancer and bilateral quadrantectomy 15 years earlier was referred to our Ocular Oncology Unit. She complained about double vision and ocular pain. Through an ophthalmological examination, she presented significant bilateral proptosis and complete ophthalmoplegia. Magnetic resonance imaging showed a diffuse soft tissue infiltration of both orbits with mild T2w fat-sat hyperintensity and T1-isointensity relative to extra-ocular muscles and a diffuse involvement of both the intra- and extra-conal compartments. Significant enlargement of the extraocular muscles without sparing the muscle tendons and eyelids soft tissue swelling were also evident. Post-contrast images showed a diffuse and bilateral contrast enhancement of the involved tissues. Due to the inconclusive imaging findings, a bilateral orbital incisional biopsy was planned. The histopathological and immunohistochemical diagnosis was of lobular breast carcinoma and the patient underwent external beam radiotherapy with consistent clinical improvement. In conclusion, post-menopausal women presenting with a history of breast carcinoma and clinical and radiographic findings suggestive of acute bilateral orbital inflammatory disease should be biopsied to rule out metastatic disease even several years from the primary tumour.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100274"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000583/pdfft?md5=d0079c5eaacddc1efa9c4aab4981ebfb&pid=1-s2.0-S2666621923000583-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nilesh M. Kalariya , Hans C. Lee , Muzaffar H. Qazilbash , Krina K. Patel
{"title":"Secondary monoclonal gammopathy of unknown significance with isotype switching after CAR T-cell therapy for multiple myeloma: A case report","authors":"Nilesh M. Kalariya , Hans C. Lee , Muzaffar H. Qazilbash , Krina K. Patel","doi":"10.1016/j.cpccr.2023.100276","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100276","url":null,"abstract":"<div><p>The incidence of secondary monoclonal gammopathy of undetermined significance is limited in patients with multiple myeloma post chimeric antigen receptor T-cell therapy. This is a case of secondary monoclonal gammopathy of undetermined significance with the appearance of distinct paraprotein peaks demonstrating isotype switching from IgA lambda to IgG lambda within 6 months post autologous chimeric antigen receptor T-cell therapy in a 66 year old multiple myeloma patient. Secondary monoclonal gammopathy of undetermined significance with or without isotype switching and/or new paraprotein bands may be a rare but important example of a benign and transient phenomenon representing pseudo-disease progression and potentially associated with longer progression-free survival and better overall outcomes. Although such association remains speculative given paucity of literature and an absence of high-quality data.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100276"},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000601/pdfft?md5=a15444bc0eb25f6d79f7dce78008bc4a&pid=1-s2.0-S2666621923000601-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}