Case Reports in Oncology最新文献

{"title":"Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case Report.","authors":"Subin Punnen, Veronika Csizmok, Connor Frey, Richard Gilbert, David F Schaeffer, Stephen Yip, Marco A Marra, Janessa Laskin, Michael Bleszynski, Daniel R Owen","doi":"10.1159/000544747","DOIUrl":"10.1159/000544747","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic hepatoid carcinoma (PHC) is a rare and poorly characterized malignancy, with approximately 50 reported cases in the literature. Pure PHC, which lacks any features of adenocarcinoma or neuroendocrine differentiation, is a subset of this population and is extremely rare. Data on its management and genomic findings are limited, and further characterization may provide helpful information in caring for these patients.</p><p><strong>Case presentation: </strong>A 42-year-old female was found to have a large, well-circumscribed mass in the body of the pancreas with elevated serum alpha-fetoprotein. Imaging demonstrated an 8.5 cm pancreatic lesion with no other disease. Endoscopic ultrasound-guided biopsy revealed a bile-producing carcinoma with morphological and immunohistochemical features consistent with hepatocellular carcinoma. She underwent a subtotal pancreatectomy and splenectomy, and pathologic evaluation confirmed a well-differentiated pure PHC confined to the pancreas. Whole genome and transcriptome analysis showed microsatellite stability, an elevated tumour mutation burden, copy number alterations in Chr19p13.3, and no mutations typically seen in pancreatic ductal adenocarcinoma (PDAC). These findings support the diagnosis of a pure hepatoid carcinoma with clinical, histopathological, and genomic characteristics resembling hepatocellular carcinoma. She remains disease free at 9 months without adjuvant therapy.</p><p><strong>Conclusion: </strong>This case demonstrates further characterization of a rare pancreatic lesion and illustrates the importance of integrated histopathological and genomic analyses in characterizing rare malignancies. Additionally, our findings suggest that pure PHC may be a distinct entity rather than a variant of PDAC.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"420-428"},"PeriodicalIF":0.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214929","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":"Thrombocytopenia in an EGFR 19 Exon-Deficient Bilateral Diffuse LUAD with ARDS Treated with ECMO and Osimertinib: A Case Report.","authors":"Donghai Liang, Fei Zhou, Chen Xu, Lili Zou, Tao Jiang, Haijun Lu, Chunliu Meng","doi":"10.1159/000544788","DOIUrl":"10.1159/000544788","url":null,"abstract":"<p><strong>Introduction: </strong>EGFR-sensitive mutations bilateral diffuse lung adenocarcinoma (LUAD) complicated with acute respiratory distress syndrome (ARDS) is relatively rare. It is important to consider whether EGFR-TKI can be simultaneously received when treating with extracorporeal membrane oxygenation (ECMO) and anti-infective therapy in these patients, and what adverse events should be noted?</p><p><strong>Case presentation: </strong>We report a case of EGFR 19 exon-deficient bilateral diffuse LUAD complicated with ARDS. When treated with ECMO and anti-infective therapy, the patient received oral osimertinib anti-tumor therapy simultaneously. The tumor receded, but eventually irreversible thrombocytopenia developed.</p><p><strong>Conclusion: </strong>For patients with severe lung cancer, anti-tumor efficacy and adverse events should be closely observed during anti-tumor therapy.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"372-380"},"PeriodicalIF":0.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669172","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":"Refractory Subcutaneous Panniculitis-Like T-Cell Lymphoma with Hemophagocytic Syndrome Treated with Romidepsin and Allogeneic Hematopoietic Cell Transplantation.","authors":"Yuki Ishizawa, Tomomi Toubai, Tsubasa Ichikawa, Masahito Himuro, Mikiya Kato, Yusuke Nagano, Ryo Takahashi, Masashi Hosokawa, Yuka Hosokawa, Akane Yamada, Takuma Suzuki, Keiko Aizawa, Satoshi Ito, Daniel Peltier, Hisayuki Yokoyama, Kenichi Ishizawa","doi":"10.1159/000544782","DOIUrl":"10.1159/000544782","url":null,"abstract":"<p><strong>Introduction: </strong>Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of cutaneous T-cell lymphoma (CTCL) that when refractory or complicated by hemophagocytic syndrome (HPS) has a poor prognosis. Romidepsin is a histone deacetylase inhibitor, but its efficacy for SPTCL is unknown. The efficacy of allogeneic hematopoietic cell transplantation (allo-HCT) is also unclear. Herein, we report a case of refractory SPTCL with HPS that was successfully treated with romidepsin followed by consolidation with allo-HCT.</p><p><strong>Case presentation: </strong>A 26-year-old female presented with fever, generalized painful erythema, pancytopenia, and hemophagocytosis. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (PET) showed diffuse PET-avid infiltration of the subcutaneous adipose tissue found to be SPTCL via skin biopsy. Her SPTCL was refractory to conventional chemotherapy but complete metabolic response was achieved after romidepsin. An allo-HCT was used for consolidation, and she remains in complete remission 3 years later.</p><p><strong>Conclusion: </strong>Romidepsin with allo-HCT consolidation may be an effective approach for refractory SPTCL.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"398-404"},"PeriodicalIF":0.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699710","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 Gestational Trophoblastic Neoplasia Leading to Acute Respiratory Failure and Death: A Case Report - About a Particularly Challenging Management in the Intensive Care Unit, and Exploring the Potential of Pembrolizumab in Treating Frail, Pretreated Gestational Trophoblastic Neoplasia.","authors":"Michel Meyers, Ahmad Awada, Marine Najmaoui, Maxime Ilzkovitz, Martina Pezzullo, Julia Chaves, Jacques Deviere, Katarina Halenarova, Aspasia Georgala, Maxime Fastrez, Frédéric Goffin, Laura Polastro","doi":"10.1159/000543518","DOIUrl":"10.1159/000543518","url":null,"abstract":"<p><strong>Introduction: </strong>Gestational trophoblastic disease (GTD) includes rare tumors from abnormal fertilization, ranging from benign hydatidiform moles to malignant choriocarcinomas (CCs) and rare placental-site trophoblastic tumors. Management of GTD depends on FIGO scoring, with low-risk cases treated conservatively and high-risk or ultra-high-risk cases requiring multi-agent chemotherapy, often EMA-CO, with induction therapy recommended for patients at very high risk of early death.</p><p><strong>Case presentation: </strong>We present the case of a 37-year-old female patient who developed an acute respiratory failure, requiring mechanical ventilation, 2 months after term delivery by cesarean section. The diagnosis of gestational trophoblastic neoplasia (GTN) was suspected due to high level of HCG in postpartum period and thoracic imaging suggesting multiple pulmonary metastases. No biopsy was available. She subsequently developed ventilator-associated pneumonia with severe acute respiratory distress syndrome (ARDS), requiring veno-venous extracorporeal membrane oxygenation support alongside concurrent polychemotherapy. After spending 61 days in the intensive care unit, and achieving biological complete remission based on HCG monitoring, the patient was transferred to the oncology ward. Due to prolonged hypoperfusion and hypoxemia, the patient developed ischemic cholangiopathy, severely constraining further therapeutic options. After 4 months of biological remission, the patient experienced a recurrence based on HCG rising and reappearing of pulmonary lesions on thoracic imaging in the lungs. In second line, the patient was treated with carboplatin, with no significant response. In third line, pembrolizumab was used, and the patient experienced a significant decrease in HCG. However, due to hematologic toxicity, we discontinued the treatment. Subsequently, the HCG level raised and the patient rapidly developed hemorrhagic cerebral metastasis and succumbed shortly thereafter.</p><p><strong>Conclusion: </strong>This case underscores the importance of prompt recognition and timely intervention in the management of patients with ARDS during the early postpartum period. GTN with lung involvement should be considered after excluding the other more frequent causes of ARDS. It also highlights how ECMO support enables the continuation of chemotherapy and the achievement of remission in CC. Furthermore, due to the inability to initiate the desired chemotherapy, immunotherapy was introduced as a possible treatment modality. Therefore, this case underscores the importance of adaptability in treatment plans based on patient-specific clinical conditions and collaborative decision-making with specialized centers. Finally, it emphasizes the efficacy of pembrolizumab, even as a monotherapy, in pretreated CC cases.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"386-397"},"PeriodicalIF":0.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699707","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":"Preoperative Systemic Chemotherapy Including Immune Checkpoint Inhibitors for Patients with Tumor-Associated Dermatomyositis.","authors":"Yukino Kawamura, Akihiko Shimomura, Tomoko Taniyama, Hoshie Hirai, Kazuki Hashimoto, Yayoi Honda, Dai Kitagawa, Hiroshi Kaneko, Chikako Shimizu","doi":"10.1159/000543579","DOIUrl":"10.1159/000543579","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICIs), used in cancer immunotherapy, enhance the immune system's ability to attack cancer cells. However, this activation can lead to severe immune-associated adverse events due to overactivation. In autoimmune diseases, the immune system mistakenly targets the body's tissues, producing autoantibodies that cause inflammation and tissue damage. Despite the increasing use of ICIs, limited information exists on their effects and potential harms in patients with active autoimmune diseases, making it challenging to predict outcomes and manage risks for these patients.</p><p><strong>Case presentation: </strong>We report a case of a patient with breast cancer presenting with a rash and muscle weakness. The simultaneous onset of these symptoms, along with the rapid growth of the breast tumor, led to a diagnosis of tumor-associated dermatomyositis (DM). The patient presented with locally advanced triple-negative breast cancer and received preoperative chemotherapy, including ICIs.</p><p><strong>Conclusion: </strong>The administration of preoperative chemotherapy, including ICIs, to a patient with breast cancer and tumor-associated DM was found to be a safe and effective treatment approach. There is a need to better understand the interplay between ICIs and autoimmune diseases and to develop safe and effective treatment strategies for this unique patient population.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"231-238"},"PeriodicalIF":0.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466877","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 Case of Uterine Serous Carcinoma: Importance of Early Detection and Comprehensive Treatment in Postmenopausal Women.","authors":"Amjad Hijazi, Gieth Alahdab, Aland Oso, Ahmad Abboud, Safa K Salman","doi":"10.1159/000542359","DOIUrl":"10.1159/000542359","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine serous carcinoma (USC) is an uncommon but highly aggressive subtype of endometrial cancer, constituting approximately 10% of all endometrial carcinoma cases. Due to its aggressive nature, it is often diagnosed at an advanced stage, with a significant proportion of patients presenting with metastasis.</p><p><strong>Case presentation: </strong>This report deals with a case of a 75-year-old postmenopausal female with a history of obesity and hypertension, presenting with abnormal vaginal bleeding over 2 years. Her obstetric history included three cesarean sections, and she had not undergone a speculum examination for 35 years. Transvaginal ultrasound revealed a heterogeneous structure with cystic changes nearly filling the uterine cavity, suggestive of an intrauterine polyp. Dilation and curettage under general anesthesia disclosed that the uterine cavity is filled with gray, soft endometrial material. Histopathological examination confirmed the diagnosis of serous papillary carcinoma of the endometrium. Subsequent imaging was unremarkable for distal metastasis. The patient underwent an abdominal total hysterectomy with bilateral adnexectomy and pelvic lymphonodectomy. Histopathology indicated high-grade papillary serous adenocarcinoma with minimal myometrial invasion and metastasis in 3 out of 10 regional lymph nodes. Postoperatively, she received 25 sessions of radiotherapy and four doses of chemotherapy with paclitaxel and carboplatin. Nine months post-surgery, the patient remains in good health and adheres to a strict monitoring protocol. This case emphasizes the necessity of comprehensive diagnostic evaluations and aggressive treatment in postmenopausal women presenting with vaginal bleeding.</p><p><strong>Conclusion: </strong>Despite its typically poor prognosis, early diagnosis and treatment of USC can lead to favorable outcomes. This case underscores the importance of timely intervention in managing postmenopausal vaginal bleeding, particularly in the context of potential malignancies.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"174-180"},"PeriodicalIF":0.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078176","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":"An ACTH-Producing Neuroendocrine Tumor: Clinical Course of Multidisciplinary Therapy Including Peptide Receptor Radionuclide Therapy - A Case Report.","authors":"Tomonobu Koizumi, Ai Sato, Kohei Kitajima, Masanori Yamazaki, Sana Kanazawa, Tsuyoshi Notake, Yoshinori Sato, Shota Kobayashi, Mai Iwaya, Takako Umeda, Mitsuhisa Komatsu","doi":"10.1159/000543177","DOIUrl":"10.1159/000543177","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical experiences of peptide receptor radionuclide therapy (PRRT) in patients with adrenocorticotropic hormone (ACTH) producing neuroendocrine tumor (NET) were extremely rare.</p><p><strong>Case presentation: </strong>A 60-year-old woman with hypertension, lower-extremity edema, hypoalbuminemia, hypokalemia, and multiple hepatic tumors was hospitalized for further examination and treatment. Endocrine testing detected excessive levels of ACTH and cortisol in her blood. Pathohistological examination revealed the hepatic lesions to be ACTH-positive grade 2 NETs (G2). A diagnosis of ectopic ACTH-producing NET was made. The patient was initially treated with the 11-hydroxylase inhibitor, metyrapone, to control hypercortisolemia and the long-acting somatostatin analog, lanreotide. Simultaneously, everolimus was continued for about 1 year. Subsequently, hepatic tumors were surgically resected, leading to successful and rapid normalization of ACTH secretion and resolution of hypercortisolemia. However, the disease relapsed and presented with multiple hepatic masses and increased ACTH 18 months after surgery. As sunitinib and subsequent streptozocin chemotherapy failed to control the disease, PRRT with ¹⁷⁷Lu-DOTATATE was performed. ACTH levels increased after initiation of PRRT, and clinical manifestations, such as pigmentation, hypertension, and hyperglycemia, were remarkable. The patient was treated with antihypertensive and antidiabetic agents, and required an increased dose of metyrapone and addition of the cortisol biosynthesis inhibitor, osilodrostat. After four cycles of PRRT, the hepatic tumors showed a remarkable reduction in size with normalization of ACTH level and withdrawal of cortisol synthesis inhibitors.</p><p><strong>Conclusion: </strong>Although PRRT was effective, we should consider the occurrence of hormonal crisis during the therapy. Due to the rarity and complexity of hormone-producing tumors, cooperation between medical oncologists and endocrinologists is important for patient management.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"181-189"},"PeriodicalIF":0.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467012","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":"Small Cell Lung Cancer with Dual Paraneoplastic Syndromes: A Case Report.","authors":"Jingjing Song, Linlin Fan","doi":"10.1159/000542763","DOIUrl":"10.1159/000542763","url":null,"abstract":"<p><strong>Introduction: </strong>Paraneoplastic syndromes are common in cancers such as lung, breast, and ovarian cancers. Still, the dual paraneoplastic syndromes of ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) and raised pancreatic enzymes at the same time are rare. EAS is due to the production of ACTH by tumors other than the pituitary gland, which stimulates the hyperplasia of the adrenal cortex to secrete excessive corticosteroids, most commonly in lung cancer. Elevated pancreatic enzymes are associated with ectopic secretion from lung cancer. Clinically, some patients with small cell lung cancer (SCLC) have atypical early clinical manifestations and may present with paraneoplastic syndrome as the first symptom.</p><p><strong>Case report: </strong>This article describes a case of a 45-year-old male patient who was admitted to the hospital with \"intermittent mild edema of both lower extremities for more than 1 month\" and showed persistent low potassium without diuretic drugs and with abnormally high blood amylase and blood lipase in the exclusion of pancreatitis. The persistent low potassium was caused by unusually high cortisol levels in patients with EAS that result from large amounts of cortisol secretion. Pancreatitis was excluded, and he was finally diagnosed with extensive-stage SCLC after bronchoscopic biopsy and histopathological confirmation. The patient presented with dual paraneoplastic syndromes of SCLC combined with EAS, high pancreatic enzymes, dual metastases, high malignancy, loss of surgical opportunities, and poor prognosis. The patient died at the end of the first cycle of chemotherapy due to the combination of IV degree of myelosuppression, metabolic alkalosis, severe infection, respiratory failure, and the rapid deterioration of his condition.</p><p><strong>Conclusion: </strong>Most of the clinical manifestations of lung cancer with paraneoplastic syndrome as the first symptom lack specificity. The paraneoplastic syndrome of lung cancer can appear in all stages of the disease, and if it appears before the diagnosis of lung cancer, it is of some significance in guiding the diagnosis of lung cancer. Meanwhile, when pancreatic lesions are excluded, we should consider malignancy-related hyperpancreatinemia.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"159-168"},"PeriodicalIF":0.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466900","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":"Interstitial Lung Disease due to Tepotinib after Durvalumab in a Patient with Lung Adenocarcinoma Harbouring MET Exon 14 Skipping Mutation: A Case Report.","authors":"Ryota Tatsuhige, Keiki Yokoo, Taku Hatakeyama, Takayuki Nagao, Satoshi Ota, Gen Yamada, Hirofumi Chiba","doi":"10.1159/000543251","DOIUrl":"10.1159/000543251","url":null,"abstract":"<p><strong>Introduction: </strong>Tepotinib is a targeted agent for patients with advanced non-small cell lung cancer (NSCLC) with MET exon 14 skipping mutation (METex14). Whereas durvalumab is an immune-checkpoint inhibitor (ICI), which has been administered to those with unresectable stage III NSCLC. The efficacy and safety of sequential treatment in patients with METex14 are unclear. Reports have suggested that the administration of tyrosine kinase inhibitors after ICIs could potentially increase the incidence of drug-induced lung injury.</p><p><strong>Case presentation: </strong>A 76-year-old female patient was diagnosed NSCLC harbouring METex14 with clinical stage IIIA (cT2aN2M0). Chemoradiotherapy and consolidation therapy with durvalumab were initiated to achieve a cure. Durvalumab was discontinued due to interstitial lung disease (ILD). After systemic disease progression was observed, tepotinib was initiated 7 weeks after the last dose of durvalumab. She developed ILD due to the sequential treatment of tepotinib after durvalumab.</p><p><strong>Conclusion: </strong>It is unclear whether tepotinib is safe in patients with METex14 after durvalumab administration. Considering the residual period of ICIs in the body, caution should be exercised when initiating molecular-targeted drugs after ICI administration in patients with NSCLC with METex14.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"144-150"},"PeriodicalIF":0.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467031","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 of a Rare Case of Immunotherapy Combination-Induced Encephalitis: A Case Report.","authors":"Pamela Sfeir, Francois Kamar","doi":"10.1159/000543215","DOIUrl":"10.1159/000543215","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors have revolutionized cancer treatment owing to their ability to activate cellular immune checkpoint pathways and mediate an antitumor activity. Due to their immunological actions, immune-related adverse events (irAEs) have become a concern. Neurological adverse events are rarely seen whether in the central or peripheral nervous system and can be potentially life-threatening. We present a rare case of occipital encephalitis following dual immunotherapy treatment in a patient with melanoma.</p><p><strong>Case presentation: </strong>A 41-year-old man diagnosed with nodular melanoma of the right torso with axillary lymphadenopathies was treated with dual immunotherapy: nivolumab and ipilimumab. After 24 weeks, patient developed right homolateral hemianopia, and imaging findings correlated with occipital encephalitis. Autoantibodies were not detected. The patient was treated with steroids and exhibited radiological improvement of his encephalitis but maintained his right hemianopia.</p><p><strong>Conclusion: </strong>Neurological side effects of immunotherapy are not very common and range from mild to severe life-threatening symptoms. Previous analyses have shown that combination immunotherapy has a higher risk of side effects than monotherapy. Diagnosis of neurological manifestations is usually made by imaging, mainly brain magnetic resonance imaging or detection of autoantibodies in the CSF. The gold standard treatment is usually corticosteroids or rarely other molecules such as IVIg or monoclonal antibodies. The prognosis is usually favorable.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"206-212"},"PeriodicalIF":0.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466955","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}