International Cancer Conference Journal最新文献

We here present a patient with a sarcomatoid renal cell carcinoma complicated by inferior vena cava tumor thrombus that we treated with nivolumab plus ipilimumab. This resulted in shrinkage of the tumor, enabling complete resection by robot-assisted laparoscopic radical nephrectomy. The patient is still alive with no evidence of recurrence.

Renal hemangiomas, including the rare subtype of venous hemangioma, are typically non-cancerous, often asymptomatic, and usually discovered incidentally during imaging studies. Here, we report a unique case of a 59-year-old African-American female with a renal venous hemangioma that initially mimicked papillary-type renal cell carcinoma (RCC-pt) on imaging studies. The patient's presentation included a long history of rectal bleeding and an incidental discovery of a hypoattenuating mass in the left kidney during a contrast-enhanced CT scan. Renal MRI revealed a 3.5 cm left renal lower pole mass, presenting as heterogeneously hyperintense on T1-weighted images and hypointense on T2-weighted images, with gradual mild enhancement post-contrast. Subsequent total nephrectomy confirmed the histopathological diagnosis of a venous hemangioma. This case underlines the need for recognizing unique imaging features of renal venous hemangiomas, contributing to the differential diagnosis of T2 dark hypoenhancing renal masses. Correct interpretation may prevent unnecessary invasive procedures and operations, thereby improving patient management and outcomes.

Whether pancreatoduodenectomy or papillary resection should be performed to achieve curative treatment for neuroendocrine tumors of the minor duodenal papilla with a diameter of ≤2 cm is controversial. We report a 35-year-old male patient with a rare case of a neuroendocrine tumor of the minor duodenal papilla. The patient was referred to our hospital from a different clinic for dilatation of his minor duodenal papilla. Duodenoscopy revealed a smooth mass of 2 cm in diameter in the minor papilla, and the biopsy specimen was diagnosed as neuroendocrine tumor G1. The patient underwent subtotal stomach-preserving pancreatoduodenectomy. Histological evaluation showed a single nodule of 15 mm in diameter in the mucosa with metastasis to the regional lymph node. The tumor cells exhibited immunoactivity against synaptophysin and chromogranin A. The molecular immunology Borstel-1 index was less than 1%, and the grade was neuroendocrine tumor G1. We reviewed the characteristics of 24 cases of patients who underwent PD for NETs of the minor duodenal papilla in English literature. In 22 of these cases, the tumor depth was described. Lymph node metastasis was observed in none of the three cases (0%) in which the tumor was limited to the intra-sphincter; however, it was noted in three (30%) of the 10 cases in which the tumor had invaded the duodenal submucosa and in eight (89%) of the nine cases in which the tumor had invaded the muscularis propria, pancreas, peripancreatic/periduodenal tissues, or duodenal serosa. Making a definitive diagnosis preoperatively or intraoperatively whether the tumor invades beyond the sphincter or not and whether regional lymph node metastasis is present may not be possible. Therefore, we believe that pancreatoduodenectomy with lymphadenectomy is preferable for curative treatment of neuroendocrine tumors of the minor duodenal papilla.

Primary adenocarcinoma of the duodenum is a rare neoplasm that is often microsatellite instability-high (MSI-H). Pembrolizumab, a monoclonal antibody, has been recently approved in Japan for treatment of MSI-H solid tumors. Lynch syndrome is a frequent hereditary cancer predisposition syndrome. It is linked to an increased risk of various types of cancer, including colorectal and endometrial cancer, and is closely related to MSI-H. We present the case of a 55-year-old woman who was diagnosed with duodenal cancer. Biopsy findings revealed MSI-H, and pembrolizumab therapy was initiated because the tumor was in contact with the left renal vein and had metastasized to the mesenteric lymph nodes of the small intestine. Subsequently, after completing two courses of pembrolizumab therapy, the patient developed duodenal stenosis and underwent surgery. Pathological analysis of the resected specimen revealed no evidence of malignancy. Given the patient's previous cancer history and the occurrence of cancer in close relatives, genetic testing of peripheral blood was performed, which revealed the diagnosis of Lynch syndrome. Furthermore, the variant responsible for Lynch syndrome was found to be a mutation of NM_000251.3:c.211 + 1G > C in MSH2.

We present the case of a 39-year-old woman with platinum-resistant ovarian cancer who was treated with pembrolizumab. After five cycles of pembrolizumab treatment, she suddenly developed cardiac tamponade with a pleural effusion. The malignant pericardial and pleural effusion had increased, while the other malignant lesions had diminished in size. After pericardial and pleural drainage, no re-accumulation occurred. Pembrolizumab was continued and the patient did not have tumor progression for > 20 months. In some patients with pembrolizumab-induced cardiac tamponade, continuation of pembrolizumab treatment may be possible if other lesions decrease in size and the pericardial effusion can be controlled after drainage.

Both pseudomyxoma peritonei and Morgagni hernias in adults are rare clinical conditions. A 70-year-old woman who was diagnosed with pseudomyxoma peritonei with Morgagni hernia underwent cytoreductive surgery and primary repair. Pseudomyxoma peritonei causes increased intra-abdominal pressure that may lead to acquired congenital diaphragmatic hernia when there is a local fragility in the diaphragmatic musculature. Parietal peritonectomy of the right diaphragmatic peritoneum can safely remove the hernia sac. The high rate of infections associated with cytoreductive surgery causes hesitation for concurrent mesh repair for Morgagni hernia. This is the first report of pseudomyxoma peritonei with Morgagni hernia. Cytoreductive surgery including parietal peritonectomy of the right diaphragmatic peritoneum plus primary repair of hernial defect was performed safely and successfully, which achieved positive short-term results for patients with pseudomyxoma peritonei-associated Morgagni hernia.

Intrahepatic cholangiocarcinoma is a condition with a poor prognosis. Traditionally, there was no cure unless important drugs such as gemcitabine, cisplatin, and tegafur/gimeracil/uracil potassium showed efficacy. Pemigatinib has recently become accessible for the treatment of intrahepatic cholangiocarcinoma with FGFR2 fusion or rearrangement gene abnormalities. Hyperphosphatemia is typically linked to pemigatinib. In the current case, pemigatinib was used to effectively treat a 48-year-old woman, and hypophosphatemia was observed. Patients with intrahepatic cholangiocarcinoma should undergo aggressive cancer multigene panel testing as well as careful monitoring of serum phosphorus levels.

Abscopal or bystander effect of radiotherapy is a rare and unpredictable outcome encountered during treatment of metastatic cancer where tumor regression is observed distant from irradiated volume. While it has been more frequently reported with malignancies like melanoma, lymphoma, and renal cell carcinoma, data regarding metastatic esophageal cancers are sparse. We describe a case of abscopal regression of distant mediastinal and upper abdominal lymph nodes in a 65-year-old gentleman whose primary esophageal tumor was irradiated with hypo-fractionated radiotherapy in an attempt to achieve local palliation. Our case study emphasizes the systemic benefit of local radiotherapy and the need for future research to investigate its utility as this clinical event poses widespread response in an otherwise dismal Stage-IV cancer with minimal treatment-related side effects.

[This corrects the article DOI: 10.1007/s13691-023-00598-7.].