International Cancer Conference Journal最新文献

Cytokeratin-positive interstitial reticulum cell (CIRC) tumor is an extremely rare malignant neoplasm and a subtype of fibroblastic reticular cell tumor, classified within the dendritic cell tumor group. We describe a case of an epicardial CIRC tumor that was resected and subsequently recurred in the left pulmonary hilum. This recurrence was treated with immunotherapy followed by radiotherapy. A 71-year-old man with a history of colon cancer incidentally had a mass bordering the epicardium on a postoperative follow-up computed tomography scan. Pericardial tumor resection was performed due to suspected metastasis from colon cancer. Histopathologically, the patient was diagnosed as a CIRC tumor (programmed death ligand 1 expression rate > 95%). Seven months after pericardial surgery, the patient was treated with nivolumab because of local recurrence in the left pulmonary hilum, but the tumor size gradually increased. Three months after the initiation of nivolumab, the patient had a completely atelectatic left lung due to tumor invasion into the left main bronchus and was treated with external beam radiotherapy of 66 Gy in 33 fractions. One and a half months after the completion of radiotherapy, the atelectasis disappeared, and aeration was greatly improved. Three months after the completion of radiotherapy, atelectasis and pericardial effusion appeared owing to tumor regrowth, and the patient died of heart failure 2 months later. This report provides insights into the efficacy of immunotherapy and radiotherapy for CIRC tumor.

Mixed-phenotype acute leukemia (MPAL) with BCR::ABL1 fusion is a rare leukemia subtype exhibiting both myeloid and lymphoid traits. Standard treatment involves chemotherapy with a tyrosine kinase inhibitor (TKI). However, establishing the optimal treatment strategy for elderly patients with MPAL with BCR::ABL1 fusion is challenging due to their intolerance to intensive chemotherapy. It has not yet been determined whether therapy with a TKI and prednisolone, a combination known to be effective in elderly patients with B-lymphoblastic leukemia with BCR::ABL1 fusion is also safe and effective for MPAL with BCR::ABL1 fusion. Here we report the first example of an elderly patient with MPAL with BCR::ABL1 fusion who was treated successfully with ponatinib and prednisolone. Despite achieving complete response with dasatinib plus chemotherapy, the patient suffered a relapse during the withdrawal of dasatinib and had two episodes of gastrointestinal bleeding attributed to the dasatinib therapy, necessitating therapy discontinuation. The treatment was then switched to a regimen of ponatinib and prednisolone, and the patient achieved and maintained complete molecular remission for over seven years without any serious adverse events. This case suggests that ponatinib, with or without prednisolone, could be a potential salvage option for elderly patients with MPAL with BCR::ABL1 fusion who suffer relapse or are intolerant to dasatinib.

Immune checkpoint inhibitors (ICIs) can cause immune-related adverse events (irAEs) in various organs. Herein, we present a rare case involving a patient with immunotherapy-related gastritis who developed refractory vomiting and anorexia after treatment with nivolumab for cutaneous malignant melanoma. The patient was treated with oral corticosteroids, but the efficacy was limited. The symptoms improved markedly after treatment with infliximab. With the increasing use of ICIs, the number of reports of gastritis due to irAEs has also increased. Health care providers treating malignancies should be aware of this side effect and know how to diagnose and treat it.

Ganglioneuroblastoma (GNB) is a rare tumour of neuroectodermal origin consisting of a varying proportion of neuroblasts and ganglion cells. GNB arises from sympathoadrenal tissue usually affecting young children. Very few cases of brain GNB have been reported in the literature. To the best of our knowledge, this is the first-ever reported case of GNB at an intraventricular location in young adults. Because of the rarity of the neoplasm, it might be confused with other tumours of intraventricular location both in radiology and histopathology. We report a very rare case, which was surgically operated on and sent for a frozen section followed by a routine report. The final diagnosis was made by Immunohistochemistry (IHC) study. The patient was treated with further radiotherapy.

SMARCA4-deficient tumors have been reported in various organs and are associated with a poor prognosis. SMARCA4-deficient undifferentiated uterine sarcoma (SDUS) was first described in 2018. Conversely, loss of SMARCA4 (BRG1) expression, as observed by immunostaining, has been observed in several cases of undifferentiated endometrial carcinoma. SDUS has considerable morphologic overlap with undifferentiated endometrial carcinoma, while there are differences in their clinicopathological features. Here, we present two cases of SMARCA4-deficient uterine tumors in patients in their 20 s: SDUS (Case 1) and undifferentiated endometrial carcinoma without SMARCA4 nuclear expression (Case 2). Using comprehensive genome profiling, we found that both cases had SMARCA4 mutations, with tumor mutation burdens of 0 and 68 Muts/Mb, respectively. Case 1 had multiple lung metastases 9 months after surgery. We treated the patients with combination of an immune checkpoint inhibitor (pembrolizumab) and a multikinase inhibitor (lenvatinib), and the response to the treatment was stable. This study presents the first report on the response to immune checkpoint inhibitor and multikinase inhibitor in SDUS.

Supplementary information: The online version contains supplementary material available at 10.1007/s13691-024-00721-2.

Follicular lymphoma is a common hematologic malignancy; however, it is less common among all malignant diseases and is difficult to suspect in advance due to the lack of specific clinical findings. Here, we report a case in which a late recurrence of corpus cancer was first suspected and finally diagnosed as follicular lymphoma. A 67-year-old female presented to our department with enlarged pelvic lymph nodes. She was diagnosed with breast cancer (HER2-posiotive with lymph node metastasis) and corpus cancer (endometrioid carcinoma grade 2, stage IA) 16 years prior, received definitive therapy and was followed up. A positron emission tomography scan was performed, and an accumulation of 18F-fluorodeoxyglucose (FDG) was detected in multiple lymph nodes, including the lymph nodes with no change in size or enlargement. We performed laparoscopic resection of the enlarged and FDG-accumulated lymph nodes and a pathological examination. The patient was diagnosed with follicular lymphoma (FL) grade 1 and is currently under observation at the Department of Hematology. FL can be considered when there is a discrepancy between the change in lymph node size and the degree of FDG accumulation. A pathological examination is useful for accurate diagnosis. Therefore, it is important to consider tissue collection; however, care must be taken to minimize the invasiveness of the procedure for the patient.

Mucinous borderline ovarian tumors (MBOTs) have a very low recurrence rate and a good prognosis, especially in the early stages, but some MBOTs occasionally recur with the progression to mucinous ovarian carcinomas (MOCs). Here, we present a case of MBOT that recurred as invasive MOC within 3 years. To examine the reason for the progression from MBOT to MOC, whole-exome sequencing of our case identified identical mutations and copy number alterations in KRAS, CDKN2A, and TP53 in both the MBOT and recurrent MOC. The recurrent MOC had a greater copy number alteration burden compared to the primary MBOT. These findings suggest that MBOT may have progressed to MOC via recurrence, wherein the increased burden of copy number alterations could be its key driver. It was also suggested that TP53 mutations already present in MBOT may contribute to the increased copy number alterations leading to MOC.

Supplementary information: The online version contains supplementary material available at 10.1007/s13691-024-00722-1.

Trastuzumab deruxtecan (T-DXd), a high-payload antibody drug conjugate, has been reported to exert potent antitumor effects and has recently shown promising efficacy against human epidermal growth factor receptor 2 (HER2)-positive adenocarcinoma. Despite its high efficacy, interstitial lung disease (ILD) is a severe adverse event (AE) associated with T-DXd. This report describes a patient who was successfully treated with a dose-reduced T-DXd challenge after recovery from ILD. Little disease progression was observed during the treatment interruption period; thus, the effect of T-DXd was considered to have been maintained. T-DXd may induce ILD, and re-administration under careful observation is considered an important option for treating patients with HER2-positive breast cancer.

Secondary spontaneous pneumothorax (SSP) due to bevacizumab has been reported in other malignancies but not in cervical cancer. We present the case of a 57-year-old woman with stage IIIB cervical cancer who developed SSP during bevacizumab chemotherapy. Despite complete remission with cisplatin-based chemoradiotherapy, she experienced a recurrence 9 months later. A thoracoscopic surgery was performed to remove a lung nodule and bulla. Subsequently, local cervical lesion recurrence and lung metastases were noted, and paclitaxel and carboplatin combined with bevacizumab were administered. After two cycles, a grade-1 left pneumothorax occurred, attributed to bevacizumab-induced tissue fragility. The patient improved within 7 days with conservative management. Bevacizumab was discontinued, and pneumothorax did not recur. This case highlights the rare occurrence of SSP in patients with cervical cancer treated with bevacizumab and underscores the importance of appropriate management of such patients, especially those who have undergone early thoracic surgery.