Case Reports in Oncological Medicine最新文献

{"title":"Fulminant Immune Checkpoint Inhibitor-Related Encephalitis (ICI-Encephalitis) Presenting Rapidly After First Infusion of Nivolumab: A Case Report.","authors":"Jonathan Markle, Audrey Garza, Alyson Auriemma, Nicholas Rushlow, Mackenzie Eickhoff, Charles Bane","doi":"10.1155/crom/6122845","DOIUrl":"10.1155/crom/6122845","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICIs) are increasingly used in oncologic clinical practice, leading to a corresponding rise in immune-related adverse events (irAEs). In this context, we present a case of fulminant ICI-associated encephalitis (ICI-encephalitis) presenting within 24 h after a single administration of nivolumab (a PD-1 inhibitor), in a patient with recurrent Hodgkin lymphoma.</p><p><strong>Case presentation: </strong>After receiving outpatient nivolumab combined with brentuximab (an antibody-drug conjugate), the patient presented with altered mental status, status epilepticus, and abnormal signal in the bilateral temporal lobes as shown on brain magnetic resonance imaging (MRI). Lumbar puncture found pleocytosis and slight elevation in protein; there was no evidence of abnormal autoantibodies or pathogenic infection. Following multidisciplinary consultation, the patient was ultimately diagnosed with ICI-encephalitis and began on empiric treatment with intravenous methylprednisolone dosed 1 g/day for 5 days, followed by 5 days of intravenous immunoglobulin (IVIG). The patient experienced resolution of electrographic seizures and gradual improvement of mental status toward baseline but had persistent short-term memory loss and did not experience complete brain MRI recovery. Ultimately, hospice placement was pursued after goals of care discussions with the patient's spouse, and the patient expired within 1 month of discharge.</p><p><strong>Conclusion: </strong>This case serves as a safety signal for rapidly presenting ICI-encephalitis following nivolumab.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"6122845"},"PeriodicalIF":0.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652969","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":"Ectopic Adrenocorticotropic Hormone Syndrome in a Patient Diagnosed With Lung Adenocarcinoma and Hospitalized Due to Diabetic Ketonuria: A Case Report.","authors":"Murat Ay, Erhan Bozkurt, Esra Özgül","doi":"10.1155/crom/6307000","DOIUrl":"10.1155/crom/6307000","url":null,"abstract":"<p><p>Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is most often a paraneoplastic manifestation of small-cell lung cancer and is rare in lung adenocarcinoma. Its features include a cushingoid appearance, skin hyperpigmentation, muscle weakness, hypertension, glucose intolerance, hypokalemia, and metabolic alkalosis resulting from nonsuppressible, ACTH-driven hypercortisolism. We report a 70-year-old man admitted with pneumonia and diabetic ketonuria without acidosis, in whom EAS secondary to a poorly differentiated lung adenocarcinoma was diagnosed. Key biochemical findings were a markedly elevated 8 a.m. plasma ACTH (149.3 pg/mL), grossly elevated serum cortisol (54.94 <i>μ</i>g/dL) with loss of diurnal rhythm, elevated 24-h urinary free cortisol, and failure of cortisol suppression after both low- and high-dose dexamethasone, with a normal pituitary MRI-a profile consistent with an ectopic ACTH source. What distinguishes this case is that the heralding presentation was a refractory metabolic emergency (hyperglycemia with diabetic ketonuria; HbA1c 6.3%, indicating no pre-existing poorly controlled diabetes) rather than the classic cushingoid phenotype. The patient deteriorated rapidly and died on the third day after CT-guided lung biopsy, before tumor-directed therapy or confirmatory ACTH immunohistochemistry could be undertaken. This case highlights that EAS from lung adenocarcinoma may present primarily as a severe metabolic emergency and that early biochemical screening and control of hypercortisolism are critical.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"6307000"},"PeriodicalIF":0.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618411","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":"Urothelial Carcinoma With Pericardial Involvement: Report of Two Rare Cases and Literature Review.","authors":"Cláudia Agostinho, Ana Sofia Patrão, Filipa Carneiro, Catarina Castelo Branco","doi":"10.1155/crom/5500331","DOIUrl":"10.1155/crom/5500331","url":null,"abstract":"<p><p>Urothelial carcinoma (UC) is the ninth most diagnosed cancer worldwide, and pericardial dissemination is uncommon. In this case report, we describe the case of a patient in a complete response after chemotherapy with cisplatin/gemcitabine and maintenance avelumab that presented with cardiac tamponade, posteriorly confirmed to be caused by pericardial involvement by UC, and the case of a patient with UC with peritoneal metastasis at diagnosis under carboplatin/gemcitabine treatment, whose disease progressed with pericardial metastasis. The clinical documentation of pericardial metastasis in living patients is rare, and the management of this condition is still not well defined. Therefore, the description of these cases is important to raise awareness of pericardial involvement as a possible manifestation of UC.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"5500331"},"PeriodicalIF":0.6,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599388","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 Sequential Multimodal Therapy for Lingual Rhabdomyosarcoma in a Young Adult: Case Report.","authors":"Jonathan Villanueva Dominguez, Josué Vázquez Arizmendi, Vianey Guadalupe Saldaña Herrera, Ivan Meneses Morales, Gabriel Ernesto Díaz Juarez, Carlos Enrique Arciniega Vega, Rowena Lopez Chávez, Azucena Ocampo Bárcenas","doi":"10.1155/crom/7742907","DOIUrl":"10.1155/crom/7742907","url":null,"abstract":"<p><p>Lingual rhabdomyosarcoma (RMS) in adults is an exceedingly rare malignancy, with very few cases reported and no standardized treatment guidelines. We present the case of a 19-year-old male diagnosed with lingual RMS who underwent sequential multimodal therapy. The patient initially received doxorubicin combined with ifosfamide chemotherapy followed by cisplatin combined with 5-fluorouracil, both of which resulted in disease progression. A third-line regimen with vincristine, actinomycin D, and cyclophosphamide (VAC) together with pembrolizumab achieved only transient stabilization and was limited by toxicity. Subsequent treatment with cetuximab together with bevacizumab induced a significant partial response with acceptable tolerance, which was consolidated with intensity-modulated radiotherapy (IMRT) to the primary site and cervical lymph nodes. Surveillance imaging confirmed durable locoregional control without evidence of systemic disease, whereas swallowing and phonation were preserved. This case illustrates the value of individualized stepwise management in adult RMS and suggests that the integration of immunotherapy and antiangiogenic therapy may provide meaningful tumor control and functional preservation in selected patients.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"7742907"},"PeriodicalIF":0.6,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547932","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":"Rare Endobronchial Presentation of Diffuse Large B-Cell Lymphoma in a Rural Midwestern Patient.","authors":"Abbey Y Jin, Deap S Bhandal, Rony Abou-Jawde, Mohannad Abu Omar, Mahmoud Said, Kathleen Spears","doi":"10.1155/crom/7294425","DOIUrl":"10.1155/crom/7294425","url":null,"abstract":"<p><p>We present a case of a rural, underserved patient from the rural Midwestern United States with an extremely unusual presentation of diffuse large B-cell lymphoma (DLBCL) in an endobronchial region. DLBCL in an endobronchial region is so rare that existing literature does not report the statistical prevalence. This case is of particular interest in the context of cancer disparities, given that oncology literature documents survival differences in lymphoma patients based on place of residence and treatment. This patient is a 68-year-old Caucasian male with an income level below the regional poverty line and who has cardiovascular comorbidities and a 72-pack-year smoking history. He currently resides alone in trailer park housing with minimal local family support. Key interventional aspects that equalize rural patient oncology outcomes include proper assessment, diagnosis, and prompt treatment of unusual or unlooked-for presentations of disease. Prior to the diagnosis, the patient presented to the hospital complaining of a cough, shortness of breath, nausea, and generalized weakness. The chest X-ray and CT revealed a suspicious consolidation in the left upper lobe; a follow-up bronchoscopy revealed an endobronchial lesion in the left lingulae. A biopsy of the tumor confirmed a rare endobronchial lymphoma and an active diagnosis of DLBCL. Following standard treatment with Rituxan-CVP, the patient is currently in remission and being treated for a lingering comorbid fungal lung infection consequent to his immunosuppressed state. His case represents a successful intervention in a rural, underserved region of an exceedingly rare lymphoma presentation.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"7294425"},"PeriodicalIF":0.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359233","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":"Beyond Tumor Control: Radiation-Induced Ascites as a Rare Complication in Gastric Cancer Management.","authors":"Vahid Mohammadkarimi, Abolfazl Khalafi-Nezhad, Nazanin Alemzadeh, Sheyda Sheykhi, Zahra Ghanbarinasab","doi":"10.1155/crom/2063269","DOIUrl":"10.1155/crom/2063269","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is a leading cause of cancer-related mortality worldwide, with gastric adenocarcinoma as the predominant subtype. Multimodal treatment includes surgery, chemotherapy, and radiotherapy, which may rarely lead to complications such as ascites.</p><p><strong>Case presentation: </strong>A 51-year-old male with poorly differentiated gastric adenocarcinoma of the pyloric region underwent chemotherapy and curative resection, achieving a complete pathological response. He subsequently received adjuvant radiotherapy (45 Gy in 25 fractions) and developed acute-onset ascites. Paracentesis yielded nonchylous fluid with elevated protein, lymphocytic predominance, and negative cytology. In the absence of validated thresholds for radiation-induced ascites, differentiation relied on excluding common causes using established parameters: serum-ascites albumin gradient (SAAG), polymorphonuclear (PMN) cell count, and adjunctive markers (e.g., ADA, triglycerides, amylase, and BNP) to rule out portal hypertensive, infectious, tuberculous, chylous, pancreatic, and cardiac etiologies. Comprehensive evaluation including PET imaging, repeat laparoscopy with peritoneal biopsies, and follow-up imaging revealed no recurrence or surgical complications. The ascites resolved after a single paracentesis without recurrence.</p><p><strong>Discussion: </strong>The diagnosis was made by exclusion, as the case is very rare and no specific biomarkers exist. Proposed mechanisms include endothelial injury, increased vascular permeability, and microthrombotic changes; however, evidence remains inferential.</p><p><strong>Conclusion: </strong>This case underscores the importance of maintaining clinical vigilance for radiation-induced ascites in postradiotherapy patients and highlights the need for prospective studies to identify predictive biomarkers and optimize radiation field planning to minimize this rare but clinically significant complication.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"2063269"},"PeriodicalIF":0.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344096","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":"Kaposi's Sarcoma and Acute Limb Ischaemia: A Possible Direct Vascular Link.","authors":"Berthe Sabine Mapoko Esson, Etienne Okobalemba Atenguena, Lionel Fossa Tabola, Rachel Tayou, Dominique Ndom Anaba, Anne Sango, Paul Ndom","doi":"10.1155/crom/3340869","DOIUrl":"10.1155/crom/3340869","url":null,"abstract":"<p><p>Acute limb ischaemia is caused by a sudden interruption in arterial flow. Its occurrence in oncology is uncommon compared with the general population. Generally considered to be part of the paraneoplastic syndrome, its occurrence in a patient with Kaposi's sarcoma (KS) raises the question of a different pathophysiology. We report a case of acute limb ischaemia in a patient with KS. The patient was 51 years old and had hyperpigmented macules on both lower limbs for 6 months, some of which had become nodules. He was recently diagnosed with HIV and had been put on treatment. He presented with purplish macules on the lower limbs, and examination of the oral cavity revealed a purplish lesion on the palate. He presented with dry gangrene of the left limb that worsened over time. A vascular link could be suggested as an explanation for acute limb ischaemia in KS.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"3340869"},"PeriodicalIF":0.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344051","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":"Triple M Syndrome Associated With Concurrent Durvalumab and Olaparib Therapy in Metastatic Cholangiocarcinoma: A Case Report.","authors":"Oliver Nilsen, Clare Senko, Allison Collins, Nicola Tomkins, Daniel Buckley, Andrew Weickhardt, Niall Tebbutt","doi":"10.1155/crom/1318038","DOIUrl":"10.1155/crom/1318038","url":null,"abstract":"<p><p>Triple M syndrome is a rare and life-threatening overlap presentation of myocarditis, myositis and myasthenia gravis, secondary to immune checkpoint inhibition. We report a case of an 80-year-old female with metastatic cholangiocarcinoma, presenting with progressive asthenia, ptosis and dysphagia, following completion of six cycles of combination chemotherapy and immunotherapy, durvalumab. Her symptoms emerged 2 weeks after the commencement of maintenance therapy with immune checkpoint inhibitor, durvalumab, and poly(ADP-ribose) polymerase inhibitor, olaparib. Biochemical investigations were suspicious for myocarditis, myositis and type 2 respiratory failure due to myasthenic crisis. Clinical findings supported the diagnosis of triple M syndrome, and she was treated with high-dose steroids, intravenous immunoglobulin and supported with non-invasive ventilation. The patient initially improved; however, her admission was complicated by a fatal retroperitoneal haemorrhage. Our case highlights the need to consider serious immune-related adverse events and escalate prompt management for overlap syndromes in the context of immunotherapy and poly(ADP-ribose) polymerase inhibitors.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT06441747.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"1318038"},"PeriodicalIF":0.6,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307285","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":"Sarcoidosis-Like Granulomatous Reaction During Adjuvant Pembrolizumab for High-Risk Resected Melanoma.","authors":"Icíar De La Fuente DomÃnguez, Pedro Sánchez Mauriño, Beatriz Teso Martín, Enrique Aranda Aguilar","doi":"10.1155/crom/9633746","DOIUrl":"10.1155/crom/9633746","url":null,"abstract":"<p><strong>Introduction: </strong>Immunotherapy with immune checkpoint inhibitors has transformed the management of advanced melanoma and resected high-risk disease. However, their use is associated with immune-related adverse events, including sarcoidosis-like granulomatous reactions-an uncommon toxicity that may be mimic disease progression or infection.</p><p><strong>Clinical case: </strong>We report the case of a 70-year-old woman with Stage IIC cutaneous melanoma (pT4bN0M0), harboring an NRAS Q61L mutation, treated with adjuvant pembrolizumab. After three cycles, she developed subcutaneous nodules, lower-limb edema, and ocular symptoms. Histological evaluation confirmed a sarcoidosis-like granulomatous reaction. Pembrolizumab was discontinued and systemic corticosteroid therapy was initiated, resulting in partial clinical improvement.</p><p><strong>Discussion: </strong>Sarcoidosis-like reactions (SLRs) are rare but clinically relevant adverse events associated with PD-1 inhibitors. Their differential diagnosis is challenging and requires exclusion of tumor progression and infectious processes. These reactions should be considered in patients receiving immunotherapy who develop atypical systemic manifestations. This phenomenon may have prognostic implications and warrants multidisciplinary management approach.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognizing immune-mediated SLRs during immunotherapy, particularly in melanoma, and underscores the need for a high index of suspicion and further evidence to guide optimal management strategies.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"9633746"},"PeriodicalIF":0.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223429","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":"Correction to \"Transformation of Classical Hodgkin Lymphoma Into Non-Hodgkin Lymphoma: Three Case Reports From the West Bank\".","authors":"","doi":"10.1155/crom/9827843","DOIUrl":"https://doi.org/10.1155/crom/9827843","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/crom/4802098.].</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"9827843"},"PeriodicalIF":0.6,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197355","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}