International Cancer Conference Journal最新文献

A 57-year-old woman with newly diagnosed breast cancer presented with diffuse skeletal pain, predominantly in the spine. Imaging, including whole-body bone scintigraphy, revealed multiple bony lesions in the skull, spine, ribs, pelvis, and femora, indicating widespread bone metastasis. Additionally, diffuse calcification was observed in the lungs, heart, and stomach, consistent with metastatic calcification. However, CT scans only showed diffuse lytic-sclerotic lesions in the skeleton without evidence of visceral calcification. The laboratory tests revealed elevated serum calcium, phosphorus, and creatinine levels, with normal parathyroid hormone (PTH) levels. This case underscores the critical role of bone scintigraphy in the early diagnosis and monitoring of metastatic bone disease in breast cancer patients. It highlights the superiority of bone scintigraphy over CT scans in detecting early-stage visceral calcification, emphasizing the importance of early recognition and management of metastatic calcification and hypercalcemia in cancer patients.

Primary lung cancer is rare in pediatric patients. Patients generally present with nonspecific and indistinct clinical symptoms, which usually cause a delay in diagnosis. We report a case of adenocarcinoma in a 17 year-old adolescent child who presented with chronic productive cough, difficulty with breathing, haemoptysis, orthopnoea, weight loss, oedema of the lower limbs and knee joints. He was chronically ill looking with obvious bony prominences, grade 4 digital clubbing, and dull percussion notes and reduced breath sounds in the lower right lung zone. The preliminary diagnosis was lung abscess and pulmonary TB but Nucleic Acid Amplification Test (gene Xpert) and microscopy for acid-fast bacilli (AFB) were negative. Chest radiography revealed a solitary nodule in the right mid-lung zone, while chest CT revealed right lobar bronchiectasis. The patient was treated with anti-heart failure drugs, antibiotics, antifungal medications, blood transfusion, and physiotherapy. He also underwent a thoracotomy and right lower lung lobectomy. The edema resolved following the initial treatment, but the cough and difficulty with breathing persisted until the patient underwent right lobectomy. Symptoms resurfaced 3 weeks after lobectomy. Histological results showed invasive adenocarcinoma of the lung; thus, a definitive diagnosis of Invasive Adenocarcinoma of the lung was made. Patients and caregivers were counseled regarding the diagnosis and need for chemotherapy, patient died four months after the establishment of diagnosis.

Thymic carcinoma is a rare and aggressive malignancy with limited treatment options, resulting in a poor prognosis. Lenvatinib, a small-molecule inhibitor targeting multiple receptor tyrosine kinases, including fibroblast growth factor receptors (FGFRs), has been approved for thymic carcinoma that progresses following platinum-based chemotherapy. However, the identification of predictive biomarkers for its efficacy remains an unmet medical need. We herein present a case of 67-year-old man with advanced thymic carcinoma who was treated with carboplatin plus paclitaxel as first-line therapy. Lenvatinib, administered as second-line therapy, achieved a durable disease control that was maintained for over 20 months-exceeding the previously reported median progression-free survival. Comprehensive genomic profiling (CGP) using the FoundationOne^® CDx assay identified an oncogenic FGFR3 S249C mutation. The case, together with supporting literature, suggests the potential role of FGFR3 mutations as therapeutic targets in thymic carcinoma. Furthermore, the presence of oncogenic mutations in lenvatinib-targeted genes may serve as predictive biomarkers for durable disease control. Given the limited availability of methods to detect oncogenic mutations, including FGFR3, in patients with thymic carcinoma, early implementation of CGP testing-even in the frontline setting-may be warranted in the future.

Yolk sac tumor (YST) occurs primarily in the gonads but rarely outside the gonads. They typically arise in the midline location, and there are only a few reports describing the colon and rectum as the primary sites of YST. Additionally, colorectal cancers containing YST-like components are rare, and in other organs, including the stomach, it is more common to describe such lesions as " yolk sac tumor-like carcinoma". Here, we report a case of colorectal adenocarcinoma with a YST-like component arising in the rectum. This is the seventh reported case of colorectal YST-like carcinoma. A 66-year-old man presented to our hospital with the chief complaint of anal bleeding. Colonoscopy revealed a 25 × 20 mm tumor located 5 cm above the anal verge. Biopsy results showed moderately differentiated tubular adenocarcinoma, cT3, cN2b, cM0, and cStage IIIC (UICC 8th edition). Subsequently, a laparoscopic abdominoperineal resection was performed. A histopathological examination of the resected specimen revealed findings of adenocarcinoma and YST-like component. Immunostaining for mismatch repair proteins revealed no abnormalities. The tumor was positive for the KRAS G12S mutation, and negative for the BRAF mutation. The overall diagnosis was adenocarcinoma with a YST-like component, pT3, pN2a, cM0, and pStage IIIB (UICC 8th edition). Six months after the surgery, metastasis was found in the liver, but at the request of the patient and their family, the decision was made not to undergo any aggressive treatment. We describe the clinical and pathological features of colorectal YST-like carcinoma that aid in its accurate diagnosis and provide treatment suggestions.

Prostate specific membrane antigen (PSMA) Lutetium-177 (Lu-177) therapy is a relatively new theranostic treatment using a targeted radioligand therapy in the treatment of metastatic prostate cancer. PSMA-Lu177 has been approved by the FDA for treatment of prostate cancer in the metastatic castrate resistant setting. Here, we present the case of a 90-year-old man with metastatic castrate resistant prostate cancer (mCRPC) and primary resistance to androgen deprivation, second-generation androgen receptor inhibitors, and docetaxel chemotherapy. Despite the lack of response to prior lines of therapy, the patient demonstrated a rapid response to PSMA-Lu177 therapy with a substantial drop in PSA level, starting from the first cycle.

Enfortumab vedotin, an antibody-drug conjugate, in combination with pembrolizumab (PEM) (EVP), has become a standard first-line regimen for patients with locally advanced or metastatic urothelial carcinoma (la/mUC). Although this combination demonstrates superior survival outcomes compared with platinum-based chemotherapy, interstitial pneumonitis has been reported in up to 10% of cases. Acute, fatal presentations, however, are exceedingly rare. We report the case of a 78-year-old man with mUC and asymptomatic interstitial lung disease, identified on baseline chest computed tomography (CT), who developed rapidly progressive and fatal drug-induced interstitial pneumonitis after three cycles of EVP. His comorbidities included diabetes mellitus, obesity, and hypertension. On day 17 of the third cycle, he presented with dyspnea, and CT of the chest demonstrated diffuse bilateral ground-glass opacities. Despite the prompt initiation of high-dose corticosteroids and broad-spectrum antimicrobials, respiratory failure progressed rapidly, and the patient died 5 days after symptom onset. Compared with prior studies, the clinical course was exceptionally fulminant and refractory to treatment. Advanced age, poorly controlled diabetes mellitus, obesity, and pre-existing interstitial lung disease may have contributed to the severe outcome, emphasizing the need for careful patient selection and rigorous respiratory monitoring when administering EVP.

Supplementary information: The online version contains supplementary material available at 10.1007/s13691-025-00837-z.

Nivolumab plus SOX chemotherapy has emerged as an effective first-line treatment for HER2-negative unresectable advanced gastric cancer, and conversion surgery following favorable treatment response is increasingly considered as a potential curative strategy. Here, we report two cases of HER2-negative esophagogastric junction cancer initially diagnosed as unresectable. Case 1 presented with splenic metastasis and tumor thrombus in the splenic vein, and Case 2 with multiple liver metastases and extensive lymph node involvement. Both cases were classified as cStage IVB. After receiving nivolumab plus SOX chemotherapy, they demonstrated significant tumor shrinkage and disappearance of distant metastases, making CS feasible. Robotic gastrectomy was successfully performed in both cases. Pathological examination revealed tumor downstaging in both, while Case 1 showed neuroendocrine carcinoma and Case 2 revealed mucinous and signet-ring cell carcinoma components. Genomic profiling before and after treatment demonstrated persistence of TP53 mutation in Case 1 and SYNE1 mutation in Case 2, with no significant changes in allele frequency. These findings suggest that while therapy-sensitive clones were eliminated, resistant clones remained. Nivolumab plus SOX chemotherapy may help make conversion surgery possible in patients with HER2-negative advanced gastric cancer. Analyzing treatment-resistant tumor characteristics pathologically and genomically could support the development of personalized therapies.

Supplementary information: The online version contains supplementary material available at 10.1007/s13691-025-00838-y.

Targeted therapy for NTRK fusion gene-positive solid tumors has been approved as tumor-agnostic, but the frequency of such tumors is extremely low (~ 1%-2%). The same is true of soft-tissue sarcoma (STS), but STS includes some histologic types with high rates of NTRK-fusion positivity such as infantile fibrosarcoma. NTRK-rearranged spindle cell neoplasm is newly defined in the current WHO classification (5th edition), and there is thus relatively high motivation to search for NTRK-fusion in STS patients depending on the background. We report the case of a 31-year-old Japanese female with no remarkable history and an NTRK fusion-positive STS with a head and neck primary tumor who was successfully treated with targeted therapy. She was referred to our hospital due to a maxillary gingival tumor that had rapidly increased over the past several months. At her referral, the patient's previous pathological review revealed (by FISH) that the NTRK fusion gene was positive. We performed a pathological review and close examination with a view to introducing a TRK inhibitor. The patient was refractory to standard chemotherapy and radiotherapy. Concurrent comprehensive genome profiling (FoundationOne^® CDx) confirmed the LMNA-NTRK1 fusion, and treatment with the TRK inhibitor larotrectinib was started. With larotrectinib treatment, the tumor shrank in size at an early stage, and the response has been maintained for > 2 years.

[This corrects the article DOI: 10.1007/s13691-025-00821-7.].