Case Reports in Oncological Medicine最新文献

{"title":"Handmade Patient-Specific Bolus Combined With Photon Radiation Therapy for Skin Cancer.","authors":"Mostafa Robatjazi, Sajedeh Sadat Jamalabadi, Sajjad Beynabaji, Hamid Reza Baghani, Seyed Alireza Javadinia","doi":"10.1155/crom/5598014","DOIUrl":"10.1155/crom/5598014","url":null,"abstract":"<p><p><b>Introduction:</b> Skin cancer is the most prevalent cancer in Iran. While surgical excision is the primary treatment, radiation therapy (RT) plays a crucial role, especially for tumors in critical anatomical locations. This case report evaluates the performance of handmade boluses for skin cancer RT using 6 MV photons. <b>Case Presentation:</b> Two patients with lip squamous cell carcinoma (SCC) and nasal basal cell carcinoma (BCC) were treated using 6 MV photon RT with handmade boluses. Dosimetric evaluation using EBT2 Gafchromic film was performed to verify the delivered radiation doses. For the lip SCC patient, the measured dose was 3.9% higher than the planned 73.85 Gy. For the nasal BCC patient, the measured dose was 3.48% higher than the planned 75.60 Gy, demonstrating the high accuracy of the handmade bolus approach. <b>Discussion:</b> The use of patient-specific, handmade boluses demonstrated several advantages, including reduced air gaps and improved dose delivery accuracy compared to commercial boluses. The consistent bolus positioning minimized interfraction setup variations, leading to lower standard deviations in the measured doses. While this study did not directly quantify the air gap, prior research has reported air gap reductions of over 72% with patient-specific boluses. <b>Conclusion:</b> This case report supports the effectiveness of handmade boluses in combination with 6 MV photons for skin cancer RT, particularly in resource-constrained settings where advanced treatment modalities may not be readily available. The handmade bolus approach provides an accessible solution to enhance the precision of skin cancer RT.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"5598014"},"PeriodicalIF":0.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315962","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":"Surgical Treatment of Solid Pseudopapillary Tumor in Pediatric Patients: Two Case Reports and a Brief Narrative Review.","authors":"Dario Talloa, Simona Cordaro, Giorgio Attinà, Stefano Mastrangelo, Alberto Romano, Anna Fregola, Palma Maurizi, Lorenzo Nanni, Antonio Ruggiero","doi":"10.1155/crom/8183273","DOIUrl":"10.1155/crom/8183273","url":null,"abstract":"<p><p>Solid pseudopapillary neoplasms (SPNs) represent a tumor of the exocrine pancreas, belonging to the group of pancreatic cystic neoplasms. It is exceedingly uncommon for SPNs to manifest in extrapancreatic locations, such as the mesocolon, greater omentum, jejunum, and ovary. SPNs are considered very rare, constituting about 0.17%-2.5% of all pancreatic neoplasms and 6% of cystic pancreatic neoplasms. We present two pediatric cases of SPNs: one involving a 16-year-old female patient and the other a 14-year-old girl, both diagnosed and treated in our center with surgical resection. The experience of our center confirms that wide margin surgery, with associated metastasectomy if necessary, represents the therapy of choice for SPNs, ensuring effective control of the disease.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"8183273"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246640","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":"Diagnostic and Therapeutic Challenges of Cardiac Metastasis in Advanced Malignancies: A Case Series and Literature Review.","authors":"Moath Albliwi, Aravinthan Vignarajah, Nishanthi Vigneswaramoorthy, Ayham Mohammad Hussein, Asfand Yar Cheema, Shimoli Barot, Gautam Shah","doi":"10.1155/crom/7374561","DOIUrl":"10.1155/crom/7374561","url":null,"abstract":"<p><p><b>Background:</b> Cardiac metastases, though more common than primary cardiac tumors, remain under-recognized due to their often subtle clinical presentation. These tumors can lead to life-threatening complications, and their diagnosis is typically delayed. <b>Objective:</b> This paper is aimed at reviewing two distinct cases of metastatic cardiac tumors, shedding light on diagnostic challenges, clinical presentations, and management approaches. <b>Methods:</b> We present two cases of patients with metastatic melanoma and undifferentiated malignant spindle cell neoplasm, respectively. Diagnostic imaging, including echocardiography and PET scans, was used to identify the cardiac masses, and biopsy results provided histopathological confirmation. Treatment plans involved systemic immunotherapy, chemotherapy, and surgical resection. <b>Results:</b> In both cases, cardiac metastases were detected through advanced imaging, despite the patients presenting with nonspecific symptoms like abdominal pain and shortness of breath. The metastatic tumor in one patient responded to immunotherapy before surgical excision, while the other patient, in advanced stages, opted for supportive care. <b>Conclusion:</b> Cardiac metastasis should be considered in cancer patients who present with unexplained cardiac symptoms. A multidisciplinary approach, including imaging and biopsy, is crucial for accurate diagnosis. Despite aggressive treatment, the prognosis remains poor, emphasizing the need for early detection and better therapeutic strategies.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"7374561"},"PeriodicalIF":0.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198338","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":"Case Report: Fatal <i>Pneumocystis jirovecii</i> Infection in an Elderly Man Receiving Adjuvant Paclitaxel and Trastuzumab Therapy for HER2-Positive Breast Cancer.","authors":"Colin Vercueil, Hamza Ouaz, Emilie Schultz, Jean Marc Limacher","doi":"10.1155/crom/5515318","DOIUrl":"10.1155/crom/5515318","url":null,"abstract":"<p><p><b>Background:</b> <i>Pneumocystis jirovecii</i> pneumonia (PJP) is a well-recognized opportunistic infection in immunocompromised patients, particularly those with hematological malignancies or HIV infection. However, its occurrence in patients with solid tumors undergoing chemotherapy remains poorly characterized. <b>Case Presentation:</b> We report the case of an 84-year-old male patient with HER2-positive breast cancer who developed severe PJP following adjuvant chemotherapy with paclitaxel and trastuzumab. The patient had no known immunosuppressive conditions and did not present chemotherapy-induced lymphopenia prior to the onset of symptoms. He was admitted with fever and dyspnea, 9 days after discontinuation of chemotherapy due to Grade 3 asthenia. Chest computed tomography (CT) revealed diffuse ground-glass opacities, and bronchoalveolar lavage confirmed the presence of <i>Pneumocystis jirovecii</i> DNA by PCR. Despite prompt initiation of sulfamethoxazole/trimethoprim and corticosteroids, the patient developed refractory acute respiratory distress syndrome (ARDS) and died after ICU admission. <b>Discussion:</b> This case highlights the potential risk of PJP in elderly patients receiving adjuvant chemotherapy, even in the absence of evident immunosuppression. Given the increasing use of chemotherapy in older populations, a thorough risk-benefit assessment should be considered, especially when the expected survival benefit is limited. Current guidelines do not recommend systematic PJP prophylaxis in patients with solid tumors, yet emerging evidence suggests that chemotherapy-related lymphopenia may increase susceptibility to opportunistic infections. <b>Conclusion:</b> Clinicians should maintain a high index of suspicion for opportunistic infections such as PJP in elderly patients undergoing chemotherapy, regardless of their immune status. This case underscores the importance of individualized risk stratification and vigilant monitoring to prevent and manage life-threatening complications.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"5515318"},"PeriodicalIF":0.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109466","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":"Dermatofibrosarcoma Protuberans of the Forehead: Case Report of a Rare Entity and Review of Literature.","authors":"Ulrich Igor Mbessoh Kengne, Jaafar Ibn Abou Talib Thiam, Amacoumba Fall, Salif Balde, Mamadou Ndiaye, Joel Gabin Konlack Mekontso, Gorgui Sarr, Etienne Tossou Zoure, Mamadou Sow, Sidy Ka","doi":"10.1155/crom/9991548","DOIUrl":"https://doi.org/10.1155/crom/9991548","url":null,"abstract":"<p><p>Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma originating from fibroblasts in the dermal connective tissue, comprising approximately 1% of all soft tissue sarcomas. While most cases involve the trunk and extremities, only 10%-15% occur in the cephalic region, representing less than 1% of all head and neck neoplasms. DFSP is notable for its high propensity for local recurrence following surgical excision and its low metastatic potential. We report a case of recurrent DFSP of the forehead extending to the anterior wall of the left frontal sinus, without brain involvement, in a 33-year-old male with a history of three prior wide local excisions. A multidisciplinary cancer team recommended systemic imatinib therapy. This case highlights the challenges of managing DFSP in an uncommon location, underscoring the importance of a multidisciplinary approach in addressing recurrent and complex presentations.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"9991548"},"PeriodicalIF":0.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076209","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":"Insidious Primary Mediastinal Large B-Cell Lymphoma in a Young Female: A Case Report and Literature Review.","authors":"Neil Gambhir, Paul Youn, Moein Bayat Mokhtari, Patricia Lin Kwan, Thida Aye, Wan Ling Lam","doi":"10.1155/crom/9983831","DOIUrl":"https://doi.org/10.1155/crom/9983831","url":null,"abstract":"<p><p>Primary mediastinal large B-cell lymphoma (PMBCL) is a highly aggressive malignancy primarily observed in female patients during their third decade of life. This rare condition, with an incidence of 0.4 per million, traditionally presents with B symptoms or compressive-based sequela such as SVC syndrome or respiratory distress. In this report, we present the case of a young female who presented for palpitations and tachycardia without cardiopulmonary compressive-based symptoms diagnosed with a large 16-cm infiltrative PMBCL localized in the left ventricle.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"9983831"},"PeriodicalIF":0.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062463","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":"Successful Treatment of Innumerable Untreated Brain Metastases With Trastuzumab Deruxtecan in Chemotherapy-Naïve HER2-Mutated Non-Small-Cell Lung Cancer.","authors":"Sara Young, Sean C Dougherty, Angela M DeRidder, Camilo E Fadul, Ryan D Gentzler","doi":"10.1155/crom/9936011","DOIUrl":"https://doi.org/10.1155/crom/9936011","url":null,"abstract":"<p><p>In non-small-cell lung cancer (NSCLC), activating human epidermal growth factor receptor 2 (HER2) mutations are found in a small subset of patients and are associated with a higher incidence of brain metastases (BMETSs), conferring poor survival outcomes. Trastuzumab deruxtecan (T-DXd) was recently approved as a second-line agent for use in patients with previously treated, unresectable, or metastatic HER2-mutated NSCLC. We present a case of HER2-mutated NSCLC with BMETS, treated with T-DXd to defer whole-brain radiotherapy (WBRT) because of the concern of long-term neurotoxicity. He initially also received bevacizumab to address the cerebral edema, which allowed stopping corticosteroids. After the first two doses, the patient had remarkable clinical and imaging (brain and systemic) responses without progression after more than 1 year of treatment. T-DXd may be an effective and durable therapy for patients with HER2-mutated NSCLC with brain metastases in situations where intracranial disease would otherwise warrant WBRT. Clinical trials are needed to understand the efficacy and durability of T-DXd in NSCLC with BMETS and the optimal sequence of available therapies.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"9936011"},"PeriodicalIF":0.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968209","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":"Sustained Remission With Atezolizumab in a Frail, Geriatric Patient With Advanced-Stage Large Cell Neuroendocrine Carcinoma Lung.","authors":"Mayank Kapoor, Praneet Bedi, Deepak Sundriyal, Ashita Jain, Ujjawal Shriwastav, Amit Sehrawat","doi":"10.1155/crom/2406678","DOIUrl":"10.1155/crom/2406678","url":null,"abstract":"<p><p>Large cell neuroendocrine carcinoma (LCNEC) is a rare, aggressive cancer primarily found in the lungs but can also occur in other organs. It is characterized by rapid progression and high metastatic potential. We present a case of advanced-stage LCNEC lung in a patient with a poor performance status (PS), requiring oxygen support. Imaging revealed a large right upper lobe mass, lymphadenopathy, with bronchial encasement and invasion into the superior vena cava, leading to SVC syndrome and pleural effusion. Biopsy and immunohistochemistry confirmed LCNEC. Due to the patient's poor PS, treatment began with low-dose single-agent chemotherapy (carboplatin), followed by etoposide and cisplatin after improvement. Local radiation was also administered, and the treatment plan was adjusted to include atezolizumab. After 10 cycles, the patient achieved complete remission, sustained for 6 years. This case highlights the complexities of managing advanced LCNEC in a geriatric patient and the effectiveness of a multidisciplinary approach and immunotherapy.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"2406678"},"PeriodicalIF":0.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11976032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810498","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":"Cases of Patients Treated in Countries With Limited Resources and Discussed by Experts of the International CML Foundation (iCMLf)-Case No. 2: Treatment-Free Remission After 9 Years of Imatinib Treatment Without Prior Achievement of Sustained Deep Molecular Response.","authors":"Mariana Bohns Michalowski, Meinolf Suttorp, Arlene Harriss-Buchan, Guiseppe Saglio, Nicola Evans, Nirmalya Roy Moulik","doi":"10.1155/crom/3942816","DOIUrl":"10.1155/crom/3942816","url":null,"abstract":"<p><p>Pediatric chronic myeloid leukemia (pCML) is a rare malignancy that nowadays is treated upfront with tyrosine kinase inhibitors (TKIs). As demonstrated in adult CML patients, achieving deep molecular response (DMR) and maintaining this status over 2 years results in the opportunity to discontinue TKI therapy. Following cessation, this treatment-free remission (TFR) status is successfully achieved by approximately 50% of the patients, while the other half experience molecular relapse within ≤ 6 months, requiring a TKI restart. As pCML accounts for only 2%-3% of all childhood leukemias, experience and familiarity with this disease, especially with stopping attempts, are still very limited. Small pCML cohorts enrolled in stopping TKI trials, with strict criteria applied for both depth and maintenance of DMR, have demonstrated the achievable TFR success rates seem comparable to adults. However, recommendations for considering TFR in pCML have yet to be defined. We report on a 9-year-old Brazilian boy diagnosed with CML in a chronic phase. He was treated with imatinib and achieved a molecular response (BCR::ABL1 transcript rate < 0.1%) at Month 12. Not achieving DMR, he responded well, but not optimally, to TKI therapy. Contrary to existing guidelines on TKI cessation in adults, after 9 years, imatinib was stopped. With a follow-up of 24 months, the patient is in TFR and now maintains DMR successfully. With the support of the International CML Foundation (iCMLf), which aims to improve outcomes for CML patients globally, this rare case from Brazil is discussed from the perspective of a pediatric hemato-oncologist from a high-income country, a pediatric hemato-oncologist from a low- and middle-income country, an adult CML hematologist, and the treating physician. Sharing cases of pCML in LMICs and highlighting the resources offered by the iCMLf, particularly the Knowledge Center (available online), will hopefully improve the expertise on pCML treatment worldwide.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"3942816"},"PeriodicalIF":0.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751356","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":"The Importance of Next-Generation Sequencing in Identifying Immunohistochemically Ambiguous Pediatric Sarcomas.","authors":"Chong Bin He, Dan Pham, Rachel S Kronenfeld, Andrew Rosenberg, Jessica Ardente, Aditi Dhir","doi":"10.1155/crom/9926653","DOIUrl":"10.1155/crom/9926653","url":null,"abstract":"<p><p>Bone and soft-tissue sarcomas encompass over 70 histologic subtypes, posing diagnostic challenges due to overlapping characteristics. Molecular analyses, such as fluorescence in situ hybridization (FISH) and reverse transcription polymerase chain reaction (RT-PCR), aid in identifying specific genomic alterations but are often limited, particularly when prior histological findings are inconclusive. Next-generation sequencing (NGS) offers high-throughput testing via a targeted sequencing panel, addressing these limitations. This case series highlights the utility of NGS in diagnosing two pediatric patients with immunobiologically ambiguous Ewing sarcoma (ES) and clear cell sarcoma (CCS), emphasizing its role as a powerful tool in solid tumor diagnosis.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"9926653"},"PeriodicalIF":0.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669211","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}