Current problems in cancer. Case reports最新文献

{"title":"Bilateral orbital metastases from lobular breast carcinoma mimicking an orbital inflammatory process","authors":"Matteo Mario Carlà ,&nbsp;Luca Ausili Cefaro ,&nbsp;Gianluca Di Fiore ,&nbsp;Giovanni Cuffaro ,&nbsp;Carola Culiersi ,&nbsp;Teresa Musarra ,&nbsp;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}

{"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 ,&nbsp;Hans C. Lee ,&nbsp;Muzaffar H. Qazilbash ,&nbsp;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}

{"title":"Unusual presentation and course of malignant melanoma of anal canal in an African-American patient","authors":"Mediha Siddiqui ,&nbsp;Joe Saad ,&nbsp;Darshan Gandhi","doi":"10.1016/j.cpccr.2023.100272","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100272","url":null,"abstract":"<div><h3>Background</h3><p>While cutaneous melanoma is common in up to 2.6% of Caucasian population, it is far less common in the African American population, up to 0.1%. Additionally, anal melanoma in particular comprises less than 1% of all melanomas and roughly 4% of anal cancers, while Spindle-cell variants are even less common, suggesting an extremely low incidence in the African American population. Definitive diagnosis can be challenging due to lack of definitive mass or pigmentation at presentation. There is a lack of good long-term studies and treatment guidelines for this malignancy with significant variation in treatment approaches and patient outcomes.</p></div><div><h3>Case description</h3><p>Here we present a case of an 63-year old African American gentleman with no significant past medical history and unremarkable colonoscopy 3 years prior, who presented with a mass in the anal canal that was found during a scheduled screening colonoscopy. The patient was completely asymptomatic at presentation. PET/CT scan showed hypermetabolic activity in the anal canal region. Patient underwent surgical excision with pathology revealing a 2.7 cm spindle cell type of malignant melanoma and promptly treated with adjuvant immunotherapy, resulting in extended progression-free survival before recurrence in the liver.</p></div><div><h3>Conclusion</h3><p>The early diagnosis of spindle cell melanoma can prompt more aggressive surgical and systemic management options resulting in extended survival, however, late recurrences are common and often refractory to standard therapeutic options.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100272"},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266662192300056X/pdfft?md5=55e893ff3c002a68c961475ac0733f89&pid=1-s2.0-S266662192300056X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100330","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":"Severe scalp ulcerations and granulomata during treatment with amivantamab","authors":"Jingjia J Zhou ,&nbsp;Lanyi N Chen ,&nbsp;Thomas Lehan ,&nbsp;Benjamin Herzberg ,&nbsp;Brian S Henick ,&nbsp;Michael Pitman ,&nbsp;Stephanie Gallitano ,&nbsp;Catherine A Shu","doi":"10.1016/j.cpccr.2023.100273","DOIUrl":"10.1016/j.cpccr.2023.100273","url":null,"abstract":"<div><p>This case series of 9 patients with NSCLC is the first to detail the presentation and treatment of ulcerative scalp lesions associated with amivantamab, a bispecific antibody which targets both epithelial growth factor receptor (<em>EGFR</em>) and mesenchymal-epithelial transition factor (<em>MET</em>). At our institution, 33 % of all patients on amivantamab develop scalp ulcerations, following a classic presentation of papulopustular eruption of the face and trunk (9/9), paronychia (9/9), and oral mucositis (7/9). The scalp lesions began as follicular pustules, progressing to vegetative ulcerative plaques within 23 weeks. Ulcerations were refractory to treatment despite trials of multiple systemic therapies, including prednisone, acitretin, cyclosporine, secukinumab, and oral antibiotics. Prednisone offered the most substantial benefit while topical wound care including dressings and washes such as ketoconazole proprionate, sodium sulfacetamide &amp; sulfur soap, salicylic acid shampoo, and Coloplast®/Duoderm®/Aquacel® dressings provided symptomatic relief. One patient also developed granulomas on her vocal cords. More research on treatment and prevention is needed, as 6/9 patients stopped amivantamab due to their skin toxicities. Meanwhile, oncologists and dermatologists must collaborate to monitor toxicities, prepare patients for the possibility of scalp ulcerations, and provide symptomatic relief whenever possible.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"13 ","pages":"Article 100273"},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000571/pdfft?md5=553ab606a6b116456bb368804ab27352&pid=1-s2.0-S2666621923000571-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191752","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":"Low-grade B-cell lymphomas in the spinal epidural space: A case series and review of the literature","authors":"Sandra Leskinen ,&nbsp;Hamza Khilji ,&nbsp;Faina Ablyazova ,&nbsp;Avraham Zlochower ,&nbsp;Manju Harshan ,&nbsp;A. Gabriella Wernicke ,&nbsp;Morana Vojnic ,&nbsp;Randy S. D'Amico","doi":"10.1016/j.cpccr.2023.100269","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100269","url":null,"abstract":"<div><p>Lymphoma rarely arises within the central nervous system and occurs most commonly in association with disseminated systemic disease. Primary epidural lymphomas of the spine are infrequently encountered and are usually high-grade, diffuse large B-cell lymphomas. Low-grade lymphomas arising in the spine are rarer than high-grades and are usually marginal zone lymphomas. While treatments for systemic high-grade lymphomas are well defined, treatment of low-grade lymphomas arising within the Dura or within the epidural space are less defined. We present two cases of primary spinal Dural- and epidural-based low-grade lymphomas diagnosed surgically and treated with local adjuvant radiation without chemotherapy. Both patients demonstrated excellent long term symptomatic and systemic disease control. We review the literature on epidural and Dural low-grade lymphomas to guide treatment of these rare lesions.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"12 ","pages":"Article 100269"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000534/pdfft?md5=8656c2390c3940dba470d65f9116121a&pid=1-s2.0-S2666621923000534-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138501300","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":"Reduced-dose carmustine (300 mg/m2) and melphalan as a conditioning regimen in multiple myeloma patients with CNS involvement: A case series","authors":"Garrett Rueda ,&nbsp;Eric Smith ,&nbsp;Nicolas De Padova ,&nbsp;Hayley Heers ,&nbsp;Ivan Komerdelj","doi":"10.1016/j.cpccr.2023.100270","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100270","url":null,"abstract":"<div><p>Single-agent melphalan remains the gold standard for conditioning chemotherapy prior to autologous stem cell transplantation (ASCT) in the multiple myeloma (MM) setting. Melphalan's distribution in the central nervous system (CNS) is limited which raises the question if single-agent melphalan is the ideal conditioning regimen for MM patients with extramedullary involvement in the CNS. Here we present two patients with MM and CNS involvement at baseline who safely received reduced-dose carmustine (300 mg/m²) and melphalan for conditioning chemotherapy prior to ASCT. While this combination has been studied previously, no studies to our knowledge added carmustine to the preparative regimen explicitly for additive CNS penetration in patients with CNS involvement.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"12 ","pages":"Article 100270"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000546/pdfft?md5=317ba326557f4aeefc515088e49dcaab&pid=1-s2.0-S2666621923000546-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480408","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":"Nodular hidradenoma of breast skin mimicking metaplastic squamous carcinoma of the breast: A case report","authors":"W. Black ,&nbsp;Y. Fang ,&nbsp;S. Syed","doi":"10.1016/j.cpccr.2023.100268","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100268","url":null,"abstract":"<div><p>Nodular hidradenoma is an uncommon benign skin tumor arising from sweat glands that most commonly present in the head and neck as an indolent protruding cutaneous nodule with external skin changes. More rarely, they may arise in the breast skin with characteristics that may mimic metaplastic carcinoma, resulting in a diagnostic dilemma for physicians. We report a case of breast skin nodular hidradenoma with an unusual presentation and initial concern for invasive metaplastic breast carcinoma on core-needle biopsy. We discuss the diagnostic challenges of this rare breast tumor with recommendations for future diagnostic strategies when concerned for skin-based breast lesions.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"12 ","pages":"Article 100268"},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000522/pdfft?md5=a86fc2f492cf1ad361479052df3ebce7&pid=1-s2.0-S2666621923000522-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453908","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":"Primary neuroendocrine carcinoma of inguinal lymph node as a plausible entity: A case report","authors":"Jane Rhyu ,&nbsp;Saeed Sadeghi ,&nbsp;Jonathan C. King ,&nbsp;Steven D. Hart ,&nbsp;Jianyu Rao ,&nbsp;Run Yu","doi":"10.1016/j.cpccr.2023.100267","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100267","url":null,"abstract":"<div><p>We report primary neuroendocrine carcinoma (NEC) of the inguinal lymph node (LN) as a plausible clinical entity. Though previously controversial and suspected to alternatively represent an atypical presentation of LN metastasis from an unknown primary, we now report the third case of isolated inguinal LN NEC. The cases strongly support this diagnosis as a separate clinical entity with indolent behavior, unlike NEC that has metastasized to the LN. Our patient was a 68-year-old female who presented with an isolated left 4 cm enlarged inguinal LN. A core needle biopsy of the mass demonstrated cores of soft tissue that were diffusely infiltrated by loosely cohesive neoplastic cells in streaming cords and clusters. The cells were hyperchromatic, enlarged, and exhibited very high nucleus to cytoplasm ratio with prominent nuclear crowding, vesicular chromatin, inconspicuous to rare nucleoli, and scant cytoplasm. Mitotic activity was robust. Immunohistochemistry staining showed positivity for synaptophysin with Ki67 &gt;80 % but was not supportive of lymphoma or Merkel cell carcinoma. The cytological diagnosis was metastatic small cell NEC. FDG-PET/CT showed intense FDG avidity of the left inguinal LN without any evidence of potential primary malignancy or distant metastatic disease. Based on 2 previous case reports with favorable outcomes, we considered primary inguinal LN NEC as a plausible diagnosis. The patient underwent surgical resection with surgical histology confirming small cell NEC in LN, and systemic therapy and radiation therapy were held off. Postoperatively, the patient has remained disease-free for 16 months. Recognition of this clinical entity is important as it carries favorable prognosis with surgery as first line therapy. Primary inguinal LN NEC should be considered in the differential diagnosis of NECs in an inguinal LN.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"12 ","pages":"Article 100267"},"PeriodicalIF":0.0,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000510/pdfft?md5=cac9a80b8b9cc214672f525a981974e7&pid=1-s2.0-S2666621923000510-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138390523","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":"Testicular seminoma relapse to the adrenal glands 25 years after primary diagnosis: A case report","authors":"Christine Federspiel Secher ,&nbsp;Thomas Wagner ,&nbsp;Anand Chainsukh Loya ,&nbsp;Gedske Daugaard ,&nbsp;Jakob Lauritsen","doi":"10.1016/j.cpccr.2023.100266","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100266","url":null,"abstract":"<div><p>Testicular seminoma is a frequent tumor in young men, and most patients are cured after primary treatment. Relapse of the disease typically occurs within the first two years and late relapse after more than 5 years is only seen in around 4 %. The predominantly site of relapse is the retroperitoneal space, and non-pulmonary metastases such as adrenal metastases are rarely seen. We here report an exceedingly unusual case of seminoma relapse with bilateral adrenal metastases 25 years after diagnosis.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"12 ","pages":"Article 100266"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000509/pdfft?md5=cab7ad2c3382d84ca2fdf93c6aa8ac36&pid=1-s2.0-S2666621923000509-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134656525","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":"A rare type of primary CD19-negative diffuse large B-cell lymphoma presenting as an infraorbital mass in the maxillary sinus","authors":"Nabil El Hage Chehade ,&nbsp;Dina Elantably ,&nbsp;Sara Ghoneim ,&nbsp;Fnu Raja ,&nbsp;Kyle Hunter ,&nbsp;William Tse","doi":"10.1016/j.cpccr.2023.100265","DOIUrl":"https://doi.org/10.1016/j.cpccr.2023.100265","url":null,"abstract":"<div><p>A 38-year-old male recently diagnosed with acute on chronic rhinosinusitis and orbital cellulitis presented with a right painful infraorbital mass and swelling. Fine needle aspiration of the mass demonstrated atypical lymphoid infiltrate highly suggestive of lymphoma. Flow cytometry and immunophenotypic analysis detected an abnormal lymphocytic population characterized by positive CD20, CD38, and CD10, however, the CD19 marker was negative. Whole-body positron emission tomography showed a sizeable hypermetabolic mass centered at the right maxillary sinus, extending into the right orbit, and several hypermetabolic lymph nodes in the right neck. A diagnosis of high-grade CD19-negative DLBCL was made and the patient was initiated on R-HyperCVAD (Rituximab- cyclophosphamide, vincristine, Adriamycin, dexamethasone) chemotherapy protocol.</p><p>The diagnosis of paranasal lymphoma may remain elusive for months leading to delays in treatment, thus a high index of suspicion is warranted. The loss of CD19 expression in DLBCL represents a diagnostic challenge because this surface marker is widely used to gate the B cells for immunophenotyping and flow cytometry analysis. It also leads to therapeutic limitations to CD19 targeting therapies.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":"12 ","pages":"Article 100265"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666621923000492/pdfft?md5=052c87af88768f431e7873740c6e9ac9&pid=1-s2.0-S2666621923000492-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92073803","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}