Case Reports in Oncological Medicine

Haider, S.;Ahmad, N.;Anaissie, E. J.;Abdel Karim, N.

2013 Case Reports in Oncological Medicine

doi: 10.1155/2013/823842pmid: 24349810

Vitamin B12 deficiency can present with various hematological, gastrointestinal and neurological manifestations. We report a case of elderly female who presented with neuropathy and vitamin B12 deficiency where the final work-up revealed polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS). This case suggests that, although POEMS syndrome is a rare entity, it can present with vitamin-B12 deficiency and thus specific work up for early diagnosis of POEMS should be considered in patients with B12 deficiency unresponsive to therapy.

Choi, Yong Jun;Shin, Jung A.;Kim, Yong Hoon;Cha, Soon Joo;Cho, Joong-Yang;Kang, Seung Hee;Yi, Seong Yoon;Lee, Hye Ran

2013 Case Reports in Oncological Medicine

doi: 10.1155/2013/492329pmid: 24324902

Neurolymphomatosis (NL) is a rare clinical disease where neoplastic cells invade the cranial nerves and peripheral nerve roots, plexus, or other nerves in patients with hematologic malignancy. Most NL cases are caused by B-cell non-Hodgkin’s lymphoma (NHL). Diagnosis can be made by imaging with positron emission tomography (PET) and magnetic resonance imaging (MRI). We experienced two cases of NL involving the brachial plexus in patients with NHL. One patient, who had NHL with central nervous system (CNS) involvement, experienced complete remission after 8 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy but relapsed into NL of the brachial plexus 5 months later. The other patient, who suffered from primary central nervous system lymphoma (PCNSL), had been undergoing chemoradiotherapy but progressed to NL of the brachial plexus.

Kapur, Sakshi;Mahal, Pradeep;Miles, Levin;Hussain, Adnan

2013 Case Reports in Oncological Medicine

doi: 10.1155/2013/414518pmid: 24349809

We report a case of a 40-year-old female who presented with dyspeptic symptoms for six months. Upper GI endoscopy revealed a submucosal nodule in gastric antrum. Using &#x201c;<i>jumbo biopsy unroofing technique</i>&#x201d; we were able to get adequate tissue for analysis. Histopathology revealed a type III gastric carcinoid. Patient was treated with laparoscopic distal subtotal gastrectomy with Roux-en-Y reconstruction and partial omentectomy. Although there was no evidence of metastasis on initial presentation, eighteen months later, patient was found to have multiple metastatic lesions in her liver. Patient&#x2019;s lesions were treated with <i>intra-arterial (hepatic artery) Yttrium-90</i>.

Furlan, Stefanie R.;Kang, David J.;Armas, Armando

2013 Case Reports in Oncological Medicine

doi: 10.1155/2013/790790pmid: 24294528

Carcinosarcoma of the prostate is an uncommon malignancy with poor long-term prognosis. The cancer is typically discovered at an advanced stage, and with less than 100 reported cases, there is limited literature concerning treatment options. Our patient presented with a history of benign prostatic hypertrophy, erectile dysfunction, and nocturia. Biopsy of his prostate indicated that the patient had prostatic adenocarcinoma, but histopathology after prostatectomy revealed carcinosarcoma. It has been over six years since this patient&#x2019;s diagnosis of carcinosarcoma. Over this span of time, he has received a radical prostatectomy, radiotherapy, and androgen ablative therapy. The patient also developed multiple lung metastases that have been treated with video-assisted thoracic surgery and stereotactic body radiosurgery. Overall, he has remained unimpaired and in good condition despite his aggressive form of cancer.

Touloumis, Zisis;Galyfos, George;Kavouras, Nikolaos;Menis, Michalis;Lavant, Laurant

2013 Case Reports in Oncological Medicine

doi: 10.1155/2013/926963pmid: 24324903

<i>Introduction</i>. Pseudomyxoma peritonei (PMP) is an uncommon surgical entity. We report a case of aggressive disease with an unusual clinical presentation and we analyze current data on diagnosis and management of PMP. <i>Case Presentation</i>. A 71-year-old male patient presented with intermittent diarrhea and loss of appetite during the last two months, without any other classic symptoms of PMP. The clinical examination was misleading due to patient&#x2019;s obesity. The radiological evaluation revealed ascites of the abdomen and possible mucocele of the appendix, whereas the laboratory exams showed high values of specific tumour markers. The patient underwent an exploratory laparotomy for definite diagnosis. Biopsies and immunohistochemical examination confirmed the diagnosis of an aggressive and extended peritoneal mucinous carcinomatosis (PMCA). The patient was programmed for adjuvant systematic chemotherapy, which was not completed due to progression of the disease. <i>Conclusions</i>. Progressed PMP can present with unspecific symptoms that mislead diagnosis. Cytoreductive surgery in combination with systematic chemotherapy could be appropriate for aggressive PMCA, even with an unfavourable prognosis.

Gong, Jun;Alkan, Serhan;Anand, Sidharth

2013 Case Reports in Oncological Medicine

doi: 10.1155/2013/862585pmid: 24371535

We present a case of a patient with HIV/AIDS who presented with a tender left lower extremity cutaneous mass over a site of previous cryptococcal infection and was found to have plasmablastic lymphoma (PBL). The incidence of PBL is estimated to account for less than 5&#x25; of all cases of non-Hodgkin lymphoma (NHL) in HIV-positive individuals. In fact, there were only two reports of extraoral PBL at the time of a 2003 review. PBL in HIV-positive individuals is an aggressive malignancy that tends to occur in middle-aged males with low CD4 counts, high viral loads, and chronic HIV infection. The definitive diagnosis can be made with biopsy which typically shows malignant lymphoid cells that stain positive for plasma cell markers and negative for B-cell markers. The most common treatment is chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens, but the overall survival rate is poor despite its relative responsiveness to chemotherapy. This case highlights the challenges that remain in improving clinical outcomes, the importance of antiretroviral therapy and HIV disease control, and a potential association between a chronic inflammatory state caused by disseminated <i>Cryptococcus</i> and tumorigenesis in individuals with PBL.

Sobinsky, Justin D.;Willson, Thomas D.;Podbielski, Francis J.;Connolly, Mark M.

2013 Case Reports in Oncological Medicine

doi: 10.1155/2013/986517pmid: 24324904

Invasive lobular carcinoma of the breast has similar patterns of metastatic disease when compared to invasive ductal carcinoma; however, lobular carcinoma metastasizes to unusual sites more frequently. We present a 65-year-old female with a history of invasive lobular breast carcinoma (T3N3M0) treated with modified radical mastectomy and aromatase-inhibitor therapy who underwent a surveillance PET scan, which showed possible sigmoid cancer. Colonoscopy with biopsy revealed a 3&#x2009;cm sigmoid adenocarcinoma. The patient underwent a lower anterior resection. Pathology showed an ulcerated, invasive moderately differentiated adenocarcinoma extending into but not through the muscularis propria. However, six of seventeen paracolonic lymph nodes were positive for metastatic breast carcinoma (ER+/PR+), consistent with her lobular primary breast carcinoma; there was no evidence of metastatic colon cancer. This case highlights the unusual metastatic patterns of lobular carcinoma.

Wakasugi, Masaki;Masuzawa, Toru;Tei, Mitsuyoshi;Omori, Takeshi;Ueshima, Shigeyuki;Tori, Masayuki;Tsujimoto, Masahiko;Akamatsu, Hiroki

2013 Case Reports in Oncological Medicine

doi: 10.1155/2013/175263pmid: 24363944

A rare case of pathological complete response of advanced rectal cancer treated by preoperative chemoradiotherapy (CRT) with oral tegafur-uracil and leucovorin is reported. A 73-year-old man with bloody stool was diagnosed with type 2 rectal cancer located 6 cm from the anal verge. Examination of biopsy specimens revealed moderately differentiated adenocarcinoma. Computed tomography scans showed no distant or lymph node metastases. With a diagnosis of advanced lower rectal cancer of T3N0M0 stage III according to the TNM classification, he underwent preoperative CRT with oral tegafur-uracil and leucovorin. He did not experience any adverse events due to CRT. An abdominal CT scan and colonoscopy after CRT demonstrated significant tumor reduction. Then, 63 days after CRT, he underwent laparoscopic-assisted low anterior resection and diverting ileostomy. Pathological examination revealed no residual cancer cells. During 15 months of follow-up after his ileostomy was taken down, the patient continued to do well without any signs of recurrence or metastasis. Preoperative CRT with tegafur-uracil and leucovorin may thus represent a safe, well-tolerated, and effective therapeutic strategy for patients with advanced rectal cancer.