Case Reports in Oncological Medicine最新文献

{"title":"Vedolizumab Dose Escalation Resolves Immune Checkpoint Inhibitor-Induced Colitis in Two Patients.","authors":"Cong Wang, Nikhil Nayee, Jacqueline M Garrick, Justin Moser","doi":"10.1155/crom/7637337","DOIUrl":"10.1155/crom/7637337","url":null,"abstract":"<p><p>Colitis is a common side effect of all currently approved immune checkpoint inhibitors (ICIs). Vedolizumab is an <i>α</i> ₄ <i>β</i> ₇ monoclonal antibody approved for treating inflammatory bowel disease (IBD) and is commonly used off-label to manage checkpoint inhibitor colitis (CIC). Previous studies have attempted dose escalation of vedolizumab for clinically unresponsive IBD patients and have been able to achieve clinical remission in 49.6% of these patients without an associated increase in adverse events. However, this has yet to be reported in patients with CIC. Here, we report on two patients who developed CIC after being treated with ICIs for metastatic cancer and received a double dose of vedolizumab. Both patients' colitis was initially treated with infliximab, steroids, and standard 300-mg vedolizumab dosage with an incomplete response. When administered a double dose of 600-mg vedolizumab, colitis symptoms were resolved without further recurrence or the need for treatment in both patients. This case series outlines effective clinical experience in treating patients with CIC refractory to standard vedolizumab dosage and supports further study of vedolizumab dose escalation in this patient population.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"7637337"},"PeriodicalIF":0.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205756","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":"Single Isolated Sacral Metastasis From Clear Cell Renal Cell Carcinoma: A Case Report.","authors":"Salah Ahmed Binziad, Mohammed Abdulla Baamer, Waleed Khaled Kaleem, Moawia Mohammed Elhassan","doi":"10.1155/crom/5545096","DOIUrl":"10.1155/crom/5545096","url":null,"abstract":"<p><p>This case report describes a rare occurrence of a single isolated sacral metastasis in a 59-year-old male with clear cell renal cell carcinoma (ccRCC). The patient presented with progressive lower back pain and sacral numbness following a fall. Initial imaging revealed a destructive lytic lesion in the S1-S2 region and a left renal mass. A CT-guided biopsy of the sacral lesion confirmed metastatic ccRCC. PET-CT confirmed no additional metastases. Multidisciplinary management included partial left nephrectomy for the primary renal tumor, stereotactic body radiotherapy (SBRT; 45 Gy/15 fractions) targeting the sacral metastasis, and immunotherapy with sunitinib. The patient experienced significant pain relief within 1-week post radiotherapy and demonstrated stable disease with near-resolution of the sacral lesion at 3-month follow-up. At 12 months, imaging confirmed sustained disease stability. This case highlights the importance of considering metastatic RCC in patients with isolated sacral lesions, even in the absence of disseminated disease, and underscores the efficacy of combining localized ablation, radiotherapy, and targeted systemic therapy. Early diagnosis and a tailored multidisciplinary approach are critical for optimizing outcomes in such rare presentations.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"5545096"},"PeriodicalIF":0.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112129","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 Type of Acinar Adenocarcinoma of the Prostate With Low PSA: A Histopathological Report of Two Cases of Pleomorphic Giant Cell Adenocarcinoma.","authors":"George S Stoyanov, Andrea Kirilova, Kristina Naydenova, Hristo Popov","doi":"10.1155/crom/7658657","DOIUrl":"10.1155/crom/7658657","url":null,"abstract":"<p><p><b>Introduction:</b> Prostate adenocarcinoma is among the leading malignant neoplastic processes in overall incidence and among the leaders of cancer-related deaths. Clinically, there is a higher risk of development in males over 50, and suspicion is increased in all cases of elevated prostate-specific antigen (PSA) levels. While the most common histologies are of conventional ductal and acinar prostatic adenocarcinoma, there are some exceedingly rare histological patterns and subtypes that vary from conventional carcinomas not only in their histological makeup but also in their presentation and aggressiveness. <b>Case Presentations:</b> Herein, we report two cases of male patients aged 75 and 60 years who presented to our institution with the leading complaint of urinary retention and gross hematuria and concomitant hydronephrosis. In both patients, the PSA levels were within normal reference values. As such, they were scheduled for transurethral resection of the prostate, with histopathology of the resected specimens showing a pleomorphic tumor process with foci of pseudoacinar structures comprised of large atypical cells with large hyperchromic nuclei, some of which had a monstrous appearance, solid tumor cell aggregates, sheets, and single tumor cells invading the parenchyma, represented mainly by large tumor cells with macroanisokaryosis, nuclear hyperchromasia, and pronounced pleomorphism. <b>Conclusion:</b> Pleomorphic giant cell prostatic carcinomas rarely present with elevated PSA or specific imaging findings and are often diagnosed incidentally, further contributing to their rarity.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"7658657"},"PeriodicalIF":0.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079591","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":"Defying the Prognostic Odds: A Case Report of Unexpected Complete Remission of Metastatic Ampullary Carcinoma With Palliative Chemotherapy.","authors":"Akil Olliverrie, Joel Gabin Konlack Mekontso, Jingwei Ren, Syed Karim, Imad Karam, Edwin Chiu, Christopher Chum","doi":"10.1155/crom/7884410","DOIUrl":"10.1155/crom/7884410","url":null,"abstract":"<p><p>Metastatic ampullary carcinoma (AC) almost always carries a poor prognosis. We present a remarkable case of a 69-year-old male with Stage IV pancreaticobiliary-type AC who achieved a complete remission after 45 months of palliative modified FOLFIRINOX chemotherapy (5-fluorouracil, oxaliplatin, leucovorin, irinotecan). This unexpected outcome challenges the conventional understanding of the natural history of advanced AC. Furthermore, molecular analysis revealed a pathogenic PALB2 mutation, along with variants of unknown significance in the POLD1 and RAD50 genes, coding for enzymes involved in various deoxyribonucleic acid (DNA) repair pathways. These findings raise questions about their potential influence on treatment response and prognosis. This case underscores the need for further investigation into the role of molecular alterations and personalized approaches in managing advanced AC.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"7884410"},"PeriodicalIF":0.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079567","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":"Nilotinib-Induced Unilateral Renal Artery Stenosis: A Complication Prompting Treatment-Free Remission in Chronic Myeloid Leukemia.","authors":"Mitchell C Boshkos, Humberto R Nieves-Jiménez, Parin H Thakkar, Juan J Cintrón-García, Omar Mamlouk","doi":"10.1155/crom/9887771","DOIUrl":"10.1155/crom/9887771","url":null,"abstract":"<p><p>Renal artery stenosis (RAS) is a rare but significant vascular complication associated with nilotinib therapy for chronic myeloid leukemia (CML). We present the case of a woman in her mid-70s on long-term nilotinib who developed this adverse event. The patient presented with a progressive, insidious decline in renal function over several years. Diagnostic evaluation revealed severe unilateral stenosis of the left renal artery. Under nilotinib, the patient had maintained a sustained deep molecular response (DMR), making her a candidate for treatment-free remission (TFR). The development of RAS prompted the discontinuation of nilotinib, both as a therapeutic intervention for her kidney disease and to initiate a trial of TFR. Following discontinuation, the patient's renal function showed partial but significant improvement, suggesting a causal relationship. This case describes the importance of recognizing subtle presentations of TKI-induced vascular complications, particularly unilateral RAS, and illustrates how managing such adverse events intersects with modern CML therapeutic goals like TFR.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"9887771"},"PeriodicalIF":0.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074435","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":"KIT-Negative Systemic Mastocytosis Associated With Acute Myeloid Leukemia.","authors":"Kabeer Ali, Tasnuva Rashid, Jennifer Miatech, Abhinav Karan, Zachary Chandler, Gerardo Diaz Garcia, W J R Quan","doi":"10.1155/crom/3563591","DOIUrl":"10.1155/crom/3563591","url":null,"abstract":"<p><p>Systemic mastocytosis (SM) is a rare blood disorder characterized by the clonal proliferation of mast cells in tissues. Mast cells release various vasoactive mediators, including histamine, leukotrienes, prostaglandins, platelet-activating factors, and cytokines such as tumor necrosis factor. Clinical manifestations can range from mild itching to severe distributive shock. In some rare cases, mastocytosis is associated with other blood disorders, such as systemic mastocytosis with associated hematologic neoplasm (SM-AHN). Almost all cases of SM exhibit a KIT point mutation. We report a rare case of KIT-negative SM associated with acute myeloid leukemia. Historically, AML has been associated with a poor prognosis, and further research is needed to understand the prognosis of SM associated with AML. In this particular case, the patient underwent induction chemotherapy with azacitidine and venetoclax, and a follow-up bone marrow biopsy showed a reduction in mastocytosis without complete hematologic recovery. The authors aim to present this case as an example of the complex nature of SM and its diverse clinical presentations.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"3563591"},"PeriodicalIF":0.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063607","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":"Leptomeningeal Carcinomatosis and Myelophthisic Anemia as Initial Manifestations of Metastatic Lobular Breast Cancer.","authors":"Ogaga Urhie, Kally Dey, Kirtan Patolia, Shiraz Fidai, Michael Alebich","doi":"10.1155/crom/5631996","DOIUrl":"10.1155/crom/5631996","url":null,"abstract":"<p><p>Breast cancer can spread to the brain and bone, usually presenting as parenchymal and osteoblastic lesions, respectively. We present a unique case of a 59-year-old woman undergoing treatment for invasive lobular breast cancer who presented with nausea, vomiting, headache, and generalized weakness. Her clinical presentation and subsequent evaluation led to a discovery of leptomeningeal carcinomatosis and myelophthisic anemia presenting simultaneously as her initial metastases. She was treated with weekly paclitaxel and intrathecal methotrexate, with noted cerebrospinal fluid response. She continues to follow up with the oncology clinic.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"5631996"},"PeriodicalIF":0.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991448","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":"Germline BRCA2 Mutation and Lynch Syndrome in a Patient With Multiple Primary Malignancies.","authors":"Morgan M Puglisi, Natasha N Dziarnowski, Bohdan Baralo, Hetal Vachhani","doi":"10.1155/crom/5879510","DOIUrl":"10.1155/crom/5879510","url":null,"abstract":"<p><p><b>Introduction:</b> Deficiency in <i>BRCA</i> genes leads to impediment in DNA repair and is associated with an increased lifetime risk of breast, ovarian, prostate, and pancreatic cancer and melanoma. Lynch syndrome is caused by inherited mutations in genes responsible for DNA mismatch repair, with resultant increase in lifetime risk of colorectal, endometrial, ovarian, stomach, urinary, pancreatic, and CNS malignancies. Here, we present a patient with a rare coexistence of both <i>BRCA2</i> and <i>PSM2</i> mutation in the setting of metastatic pancreatic and prostate cancer. <b>Case Presentation:</b> The patient was initially diagnosed with metastatic prostate adenocarcinoma at the age of 57, when a screening PSA of 22.9 warranted biopsy and staging scans revealed involvement of the aortocaval lymph node. Treatment with androgen deprivation therapy with the addition of abiraterone and prednisone was initiated. Additionally, a PET scan showed a hypermetabolic isolated lung nodule, which upon wedge resection showed Stage I lung cancer. Three years later, a pancreatic mass and multiple liver lesions were found on a surveillance scan. Biopsy confirmed the diagnosis of pancreatic cancer, and germline testing revealed the coexistence of <i>BRCA2</i> and <i>PMS2</i> mutations. The patient completed four cycles of cisplatin and gemcitabine, followed by the initiation of olaparib as per the POLE study. About 12 months after the diagnosis of metastatic pancreatic cancer and 4 years after the diagnosis of metastatic prostate cancer, the patient has excellent control of the disease with performance status ECOG 0 and minimal side effects from maintenance therapy. <b>Conclusion:</b> This case presents a unique combination of two coexistent inherited syndromes with the approximate combined incidence of 1:357,000. The presence of two advanced malignancies in our patient underlines the cumulative effects of combined deficiency in the DNA repair pathway and possibly an even higher lifetime risk of cancer. This may explain the presence of lung cancer with a minimal smoking history of less than 10 pack years. PARP inhibitors may be effective in controlling metastatic pancreatic cancer, and thus, genetic counseling is important for this patient and his family members, who will need appropriate cancer screening. The probability of carrying two pathogenic variants may be expected to increase as a result of next-generation sequencing and germline testing.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"5879510"},"PeriodicalIF":0.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944153","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":"Adding Docetaxel to Tepotinib to Overcome Oligoprogression in MET Exon 14 Skipping-Mutated NSCLC When Local Therapy Is Unfeasible: A Case Report.","authors":"David Sánchez García, Beatriz Grau Mirete, Paula Rodríguez Payá, Asia Ferrández-Arias, Miguel Borregón-Rivilla, Antonio-David Lázaro-Sánchez, Javier-David Benítez-Fuentes","doi":"10.1155/crom/4483379","DOIUrl":"10.1155/crom/4483379","url":null,"abstract":"<p><p>Oligoprogression in MET Exon 14 skipping (METex14)-mutated non-small cell lung cancer (NSCLC) is clinically challenging, particularly when local therapies are contraindicated. We report the first documented case of a 62-year-old man with oligoprogressive METex14-positive NSCLC who achieved a sustained metabolic response following the addition of docetaxel to ongoing tepotinib therapy after progression on tepotinib monotherapy. Due to prior thoracic irradiation, reirradiation and surgical interventions were deemed not feasible, prompting this systemic combination to maintain MET inhibition while targeting resistant tumor clones. This strategy resulted in a partial metabolic response at the primary lung lesion and a sustained complete metabolic response in an adrenal metastasis. The regimen was generally well tolerated; however, Grade 3 peripheral edema required dose reduction of tepotinib. This case supports the potential role of systemic therapy intensification in METex14-driven NSCLC, highlighting the therapeutic value of continued MET inhibition beyond disease progression, particularly when local treatment and advanced molecular monitoring such as ctDNA are unavailable. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT05439993.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"4483379"},"PeriodicalIF":0.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12381406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944104","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 T-Large Granular Lymphocytic (T-LGL) Leukemia in a Patient With Rheumatoid Arthritis With Neutropenia and Low LGL Level.","authors":"Muhammad Daniyal, Anamm Polani, Pavel Bleik, Jeffrey Allerton","doi":"10.1155/crom/5013991","DOIUrl":"10.1155/crom/5013991","url":null,"abstract":"<p><p>T-large granular lymphocytic (T-LGL) leukemia is a rare hematological malignancy characterized by clonal expansion of cytotoxic T-cells resulting in cytopenias. The diagnostic criteria for T-LGL leukemia necessitated a sustained peripheral blood elevation of LGLs exceeding 2 × 10⁹/L for a minimum duration of 6 months, in the absence of an identifiable etiology. In most of the cases, it is associated with autoimmune disorders such as rheumatoid arthritis. As cytopenias, including neutropenia, can be an early manifestation of the disease, they may get confused with Felty's syndrome, resulting in delayed diagnosis and treatment. Hence, we are presenting a rare case of diagnosing T-LGL leukemia in a patient with rheumatoid arthritis with neutropenia and low LGL level.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2025 ","pages":"5013991"},"PeriodicalIF":0.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944139","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}