Case Reports in Oncology最新文献

{"title":"Primary Mediastinal Large B-cell Lymphoma: A Diagnostic Conundrum.","authors":"Yazan Alrefai, Shruti Wadhwani, Nikita Wadhwani, Ayrton Bangolo, Jason Mizrahi, Tatyana Feldman","doi":"10.1159/000545931","DOIUrl":"10.1159/000545931","url":null,"abstract":"<p><strong>Introduction: </strong>Primary mediastinal large B-cell lymphoma (PMBCL) is a rare and aggressive non-Hodgkin lymphoma originating from mediastinal thymic B cells. Its peculiar molecular signature assists in differentiating it from other subtypes of non-Hodgkin lymphoma.</p><p><strong>Case report: </strong>We present a rare case of PMBCL in a 39-year-old male with a bulky mediastinal mass that resulted in superior vena cava thrombosis and cardiac tamponade. Diagnostic discordance between histopathological and molecular data led to a delay in interception of this entity. Histopathology findings were suggestive of spindle-cell neoplasm. Contrastingly, next-generation sequencing (NGS) and immunohistochemistry (IHC) yielded a molecular diagnosis of PMBCL. IHC staining revealed that the atypical cells were positive for CD20, PAX5, CD79a, CD30, CD23, MUM1, and weakly positive for MAL (myelin and lymphocyte) protein. NGS showed increased expression of TNFRSF8 and CD274 genes, which encode CD30 and PDL1 proteins, respectively. The patient was successfully treated with the R-Hyper-CVAD protocol without consolidative radiotherapy.</p><p><strong>Conclusion: </strong>Diagnosing PMBCL can be challenging because it lacks pathognomonic features and shares characteristics with other lymphomas. Molecular testing is of paramount importance in this context owing to its distinctive immunophenotype.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"711-719"},"PeriodicalIF":0.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246636","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":"\"Attenuated\" Pulmonary Tumor Thrombotic Microangiopathy on Anti-Vascular Endothelial Growth Factor Treatment: A Case Report.","authors":"Haruka Ozaki, Takeshi Yamaguchi, Rika Kizawa, Yuko Tanabe, Koichi Suyama, Yuji Miura","doi":"10.1159/000543930","DOIUrl":"10.1159/000543930","url":null,"abstract":"<p><strong>Introduction: </strong>Antemortem diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM) is challenging because of rapidly worsening respiratory failure. Vascular endothelial growth factor (VEGF) is involved in PTTM pathogenesis; however, the clinical picture of PTTM in patients with cancer receiving anti-VEGF treatment is unknown.</p><p><strong>Case presentation: </strong>A 40-year-old man with advanced gastric adenocarcinoma on paclitaxel plus ramucirumab developed a dry cough and, after 2 months of a stable period, dyspnea on exertion. Chest computed tomography (CT) showed bilateral diffuse patchy ground-glass opacities (GGOs). Transbronchial biopsy revealed alveolar hemorrhage and small pulmonary arteries occluded with fibrocellular intimal proliferation, but no tumor cells. Suspecting chemotherapy-induced lung injury, we discontinued the chemotherapy and monitored him carefully without treatment. However, his dyspnea worsened, and follow-up chest CT showed worsening GGOs and right atrial and pulmonary arterial dilatation. Ultrasound cardiography indicated reduced right ventricular function. Lung perfusion scintigraphy confirmed numerous bilateral defects. Right heart catheterization revealed pulmonary hypertension, but no tumor cells on pulmonary wedge aspiration cytology. We clinically diagnosed the patient with PTTM. Three weeks after his initial visit for dyspnea, he was started on nivolumab. One week after treatment, he required home oxygen therapy at 1 L/min on exertion. After two doses of nivolumab, he no longer had dyspnea and discontinued oxygen therapy. Follow-up ultrasound cardiography showed normal pulmonary arterial pressure, and almost all GGOs on chest CT were resolved.</p><p><strong>Conclusion: </strong>VEGF inhibitors may attenuate PTTM symptoms. Even with mild respiratory symptoms, oncologists should consider PTTM in patients with cancer on VEGF inhibitors.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"659-666"},"PeriodicalIF":0.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233277","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":"Spinal Metastases from Gastrointestinal Stromal Tumor: A Case Report.","authors":"Pashayar P Lookian, Luke J Weisbrod, Jordan M Rasmussen, Landon D Ehlers, Jie Chen, Tyler R Teichmeier, Miki Katzir","doi":"10.1159/000543568","DOIUrl":"10.1159/000543568","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal stromal tumors (GISTs) arise from the interstitial cells of Cajal and are the most common form of gastrointestinal (GI) mesenchymal tumors. Bony metastasis is rare, with the spine being the most common location of osseous metastasis.</p><p><strong>Case presentation: </strong>A 56-year-old female with presentation of acute on chronic mechanical low back pain was found to have multiple lytic lesions throughout the thoracolumbar spine arising from GIST metastases. Magnetic resonance imaging of the thoracic spine revealed a dorsal epidural enhancing mass spanning the T6-T8 levels with associated spinal cord compression and spinal cord signal change. The patient underwent urgent surgical decompression and resection of epidural tumor through T5-T8 decompressive laminectomy. Postoperatively, the patient initially did well with improvement in bilateral lower extremity sensation and bladder function. The patient passed away while at home due to undetermined causes 6 weeks postoperatively.</p><p><strong>Conclusion: </strong>Here we present the case of a patient with metastatic GIST to the thoracic spine presenting with acute spinal cord compression treated with surgical resection, in addition to reviewing the literature of previous patients with metastatic GIST to the spine. We recommend that patients undergo surgical resection with adjuvant tyrosine kinase inhibitor therapy.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"675-681"},"PeriodicalIF":0.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246638","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":"Double Trouble: Synchronous Small Cell Carcinoma and Adenocarcinoma of the Pancreas - Case Report.","authors":"Raj Jessica Thomas, Mohammad Zeineddine, Arjun Chatterjee, Michael Cruise, Smitha Krishnamurthi, Prabhleen Chahal","doi":"10.1159/000545467","DOIUrl":"10.1159/000545467","url":null,"abstract":"<p><strong>Introduction: </strong>Simultaneous presentation of primary tumors involving one isolated organ is few and far between. Pancreatic small cell carcinoma is unique, and it is rare to have both adenocarcinoma and small cell carcinoma present in unison within the pancreas.</p><p><strong>Case presentation: </strong>Presented is a 61-year-old male who was found to have synchronous small cell carcinoma and adenocarcinoma of the pancreas confirmed by endoscopic ultrasound-guided fine needle biopsy.</p><p><strong>Conclusion: </strong>This case stands as a reminder that synchronous pancreatic cancer is a rarity and possibility of multiple primary malignant tumors of different origins ought to be considered when multiple tumors are present within the pancreas.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"653-658"},"PeriodicalIF":0.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233278","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":"Durable Response in <i>NTRK</i> Fusion-Positive Advanced Salivary Gland Tumor: A Case Report.","authors":"George A Oblitas Alca, Lizeth Ayala Loma, Lisde González, Pedro Vega, Yashira L Negrón Abril, Daniel Sumarriva","doi":"10.1159/000545744","DOIUrl":"10.1159/000545744","url":null,"abstract":"<p><strong>Introduction: </strong><i>NTRK</i> fusions lead to the production of constitutively active TRK proteins, which drive oncogenesis in approximately 0.2% of cancers. However, these fusions occur more frequently in salivary gland-type tumors, making them a promising therapeutic target in patients with advanced disease. Recent studies have shown that TRK inhibitors, such as entrectinib, larotrectinib and repotrectinib, are effective in treating solid tumors harboring <i>NTRK</i> gene fusions. This underscores the importance of incorporating comprehensive molecular profiling in these tumors to identify actionable biomarkers and broaden treatment options.</p><p><strong>Case presentation: </strong>Here, we present the clinical journey of a patient diagnosed with unresectable salivary gland carcinoma that was refractory to both local and systemic treatments. Following molecular profiling, NTRK targeted therapy was initiated, resulting in a significant and sustained response.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first reported case in Bolivia of a salivary gland tumor with an <i>NTRK</i> fusion identified through molecular profiling, followed by successful treatment with compassionate use of entrectinib. This case not only demonstrates the therapeutic benefits and safety of NTRK inhibitors but also underscores the importance of personalized therapy guided by molecular profiling in oncology.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"830-835"},"PeriodicalIF":0.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367963","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":"Bilateral Malignant Brenner Tumor of the Ovary.","authors":"Ahmad Al-Bitar, Ayla Kouli, Ibrahim Dabbour, Luna A AlMardini, Abdalkarim H Alnaser","doi":"10.1159/000546358","DOIUrl":"10.1159/000546358","url":null,"abstract":"<p><strong>Introduction: </strong>Brenner tumors (BTs) are rare ovarian neoplasms, with malignant variants constituting 1-5% of cases. Typically occurring in women aged 50-70 years, malignant BTs often manifest with nonspecific symptoms such as abdominal pain and weight loss. Their etiology remains unclear, and a definitive diagnosis requires histopathological confirmation.</p><p><strong>Case presentation: </strong>A 54-year-old Arab woman, a long-term smoker, presented with a 3-month history of abdominal pain, weight loss, and distension. Imaging revealed bilateral adnexal masses (left: 14 cm; right: 13 cm) with cystic degeneration, while tumor markers (CA-125, CEA) remained normal. Exploratory laparotomy identified bilateral ovarian tumors and omental metastasis. Histopathology confirmed a high-grade malignant BT, supported by immunohistochemistry. The patient underwent total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and six cycles of carboplatin-paclitaxel chemotherapy. Surveillance imaging at 8 months showed no recurrence.</p><p><strong>Conclusion: </strong>This case illustrates the diagnostic complexity of malignant BTs due to nonspecific symptoms, normal tumor markers, and imaging limitations. Bilateral involvement, though uncommon, underscores tumor aggressiveness. Standard surgical cytoreduction and platinum-based chemotherapy achieved a favorable interim outcome, aligning with epithelial ovarian cancer protocols.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"786-793"},"PeriodicalIF":0.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367961","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 Case Report of a Patient with Multiple Bone Metastases from Prostate Cancer Achieving Complete Remission for 6 Years after Chemotherapy Combined with Endocrine Therapy.","authors":"Zhicheng Lu, Jian Sun, Ke Xu","doi":"10.1159/000545854","DOIUrl":"10.1159/000545854","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer is one of the most common malignant tumors in men, and bone metastasis is a common complication that severely affects patients' quality of life and survival rates.</p><p><strong>Case presentation: </strong>This article reports a case of a patient with multiple bone metastases from prostate cancer who achieved complete remission and survived for 6 years following chemotherapy combined with endocrine therapy.</p><p><strong>Conclusion: </strong>By detailing the patient's treatment process and follow-up results, the article explores the application value of chemotherapy combined with endocrine therapy in the management of bone metastases in prostate cancer.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"836-844"},"PeriodicalIF":0.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504918","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":"Cardiac Metastasis in Upper Tract Urothelial Carcinoma with Squamous Differentiation.","authors":"Ahmad Al-Bitar, Ayla Kouli, Joudi Talaba, Mariah Azarpayk, Muhamad Al Tawil","doi":"10.1159/000546330","DOIUrl":"10.1159/000546330","url":null,"abstract":"<p><strong>Introduction: </strong>Upper tract urothelial carcinoma, accounting for 5-10% of urothelial malignancies, rarely metastasizes to distant sites such as the heart.</p><p><strong>Case presentation: </strong>This report describes a rare case of cardiac metastasis in a 62-year-old male with a complex history of recurrent urothelial carcinoma. Initially diagnosed with bladder cancer in 1999, the patient underwent multiple resections and intravesical therapies, followed by cystectomy in 2012 due to refractory anaplastic tumors. A decade later, he developed right-sided hydronephrosis and hematuria, prompting a nephroureterectomy, which revealed papillary urothelial carcinoma with squamous differentiation (pT3pNxMx). Despite aggressive local management, cardiac metastasis involving the right ventricular myocardium was identified in 2023. Systemic chemotherapy yielded minimal response, and the patient eventually succumbed to progressive cardiac failure.</p><p><strong>Conclusion: </strong>Squamous differentiation in urothelial carcinoma predicts aggressive, treatment-resistant behavior. Delayed post-cystectomy recurrence supports the concept of field cancerization and necessitates lifelong surveillance. A rare cardiac metastasis confirms the hematogenous spread potential and underscores the need for improved adjuvant therapies.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"763-772"},"PeriodicalIF":0.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324497","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":"Immune-Related Fulminant Myocarditis Revealed Using Myocardial Histopathology at Autopsy in the Treatment of Advanced Renal Cell Carcinoma: A Case Report.","authors":"Yuka Hayashi, Yoshihide Kawasaki, Hiromichi Katayama, Rie Sakagami, Takuro Goto, Tomonori Sato, Yohei Satake, Takuma Sato, Naoki Kawamorita, Shinichi Yamashita, Hiroyuki Takahama, Satoko Sato, Akihiro Ito","doi":"10.1159/000546288","DOIUrl":"10.1159/000546288","url":null,"abstract":"<p><strong>Introduction: </strong>Although immune checkpoint inhibitor-associated myocarditis is relatively rare, it has the highest mortality rate among all immune-related adverse events, at 30-50%.</p><p><strong>Case presentation: </strong>We encountered a case of advanced renal cancer in which immune checkpoint inhibitor-associated myocarditis was confirmed on autopsy. A 78-year-old man was diagnosed with a left renal tumor secondary to hematuria. A tumor biopsy was performed, and the tumor was diagnosed as cT4N0M1 clear cell renal carcinoma, which was classified as poor risk by the International mRCC Database Consortium. Combination therapy with pembrolizumab and axitinib was initiated. One month later, the patient developed anorexia, dizziness, and fatigue, which were judged to be adverse events due to systemic therapy, and the patient was admitted to the hospital urgently. After admission, the patient experienced a sudden drop in blood pressure and loss of consciousness and was referred to a cardiologist for treatment. Blood tests showed elevated brain-type natriuretic peptide levels, but echocardiography showed good cardiac function. However, soon thereafter, the patient developed tachycardia, and echocardiography revealed a significant decline in systolic function, leading to the diagnosis of immune checkpoint inhibitor-associated myocarditis. Despite intensive care in the cardiac high-care unit and steroid administration, the patient died. An autopsy revealed necrotic changes in the myocardium, loss of myocardial cells, and severe lymphocyte infiltration, leading to a diagnosis of inhibitor-associated myocarditis.</p><p><strong>Conclusion: </strong>Delay in the initiation of treatment is considered a risk factor for poor prognosis, and the administration of high-dose steroids within 24 h of onset contributes to a better outcome. Herein, we discuss the pathology, diagnosis, and treatment of immune checkpoint inhibitor-associated myocarditis.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"738-743"},"PeriodicalIF":0.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301183","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":"Isolated Intramedullary Spinal Cord Metastasis from Nasopharyngeal Carcinoma: A Case Report and Systematic Review.","authors":"Thanawat Chanphaisit, Janjira Petsuksiri, Wajana Thaweerat, Phawin Keskool, Pornsuk Cheunsuchon","doi":"10.1159/000546064","DOIUrl":"10.1159/000546064","url":null,"abstract":"<p><strong>Introduction: </strong>Nasopharyngeal carcinoma (NPC) is rare, with distant metastases often found in bones, lungs, and liver. Intramedullary spinal cord metastasis (ISCM) is extremely uncommon, and the optimal treatment remains unclear. We report a case of isolated ISCM in a patient with NPC and provide a systematic review of the literature.</p><p><strong>Case presentation: </strong>A 31-year-old male with stage IVA (T4N2M0) NPC received induction chemotherapy, followed by concurrent chemoradiation. The patient later developed isolated ISCM without other locoregional or distant metastases. Surgical resection and postoperative radiotherapy were then performed. A systematic literature search followed PRISMA guidelines using the MEDLINE and Embase databases to identify articles describing ISCM in NPC. The extracted data included the demographics, staging, treatment, and outcomes. Among 1,040 articles (1970-2024), 42 met the initial criteria, and seven specifically addressed ISCM. Only 3 cases involved truly isolated intramedullary metastases. ISCM is likely to spread through cerebrospinal fluid dissemination. Most reports describe palliative treatments, including surgery, radiation, and chemotherapy.</p><p><strong>Conclusions: </strong>Isolated ISCM from NPC is extremely rare. Aggressive local therapy may improve symptoms and prolong patient survival. Multimodal approaches, including surgery and radiotherapy, are often required; however, the overall prognosis remains unknown.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"728-737"},"PeriodicalIF":0.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301184","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}