International Cancer Conference Journal最新文献

Solid adenocarcinoma with signet-ring cell features (SRCF) is an extremely rare variant of lung adenocarcinoma, often mimicking metastatic tumors from other sites. Accurate diagnosis relies heavily on immunohistochemical profiling. This report discusses a case of solid adenocarcinoma with SRCF presenting with pleural thickening, highlighting diagnostic challenges and treatment limitations. We report a 36-year-old smoker with progressive dyspnea and pleuritic pain. Imaging revealed pleural thickening and pulmonary nodules. Histopathology showed solid adenocarcinoma with SRCF, confirmed by immunohistochemistry as primary pulmonary signet-ring cell carcinoma (SRCC). Despite chemotherapy, the disease progressed, and the patient succumbed within 3 months. Primary pulmonary solid adenocarcinoma with SRCF is associated with high mortality and diagnostic complexity. Immunohistochemical markers remain pivotal in establishing its pulmonary origin. This case reinforced the urgent need for better diagnostic techniques and therapies.

Graphical abstract:

NTRK gene fusions serve as oncogenic drivers in solid tumors. While these fusions are uncommon in prostate cancer, they can be detected through cancer genome profiling tests. In a study of 68 prostate cancer cases analyzed with comprehensive cancer genome profiling, we identified a single instance of a novel EFNA1-NTRK1 fusion. The patient, a 56-year-old male diagnosed with prostate cancer and bone metastasis, presented with an initial PSA level of 323 ng/mL, a Gleason score of 4 + 4, and was classified as cT3bN0M1b. He underwent combined androgen blockade therapy but progressed to castration-resistant prostate cancer after 31 months. Despite previous treatments with androgen receptor signaling inhibitors and chemotherapies, the cancer continued to advance. Following the identification of an EFNA1-NTRK1 gene fusion via a cancer genome profiling test, the patient received treatment with larotrectinib. Although the initial biopsy showed positive pan-TRK staining in the prostate cancer tissue, the response to larotrectinib was limited in this case.

Here, we report a case of scar perforation caused by endoscopic dilation while the patient was waiting for additional gastrectomy after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer. Although conservative treatment prevented the progression of generalized peritonitis, one-stage meticulous surgery was contraindicated because of abscess formation around the pylorus, which is the main target of lymphatic dissection. Therefore, we performed a two-stage surgery. Prior laparoscopic gastrojejunal bypass for peritonitis control and nutritional management allowed for uncompromised curative gastrectomy using a robotic approach. Among the various treatment strategies, our selected two-stage surgery was useful in achieving uncompromised cancer surgery in patients with perforated peritonitis after noncurative ESD, where prophylactic dissection was the primary objective.

Supplementary information: The online version contains supplementary material available at 10.1007/s13691-025-00766-x.

Hydrogel spacers can be inserted to create a gap between the prostate and rectum prior to radiotherapy for prostate cancer, enabling higher radiation doses while reducing rectal toxicity. Spacer infection is relatively rare but significant. We report a case of robot-assisted radical prostatectomy performed for spacer infection and prostate cancer. A 75-year-old man with a hydrogel spacer presented with fatigue and fever after completing 30 Gy of radiation therapy for prostate cancer. He was diagnosed with a periprostatic abscess associated with the hydrogel spacer. Following antibiotic treatment, he underwent robot-assisted radical prostatectomy with concurrent abscess drainage. The treatment outcome was favorable. This case of a radical prostatectomy conducted for spacer infection represents, to our knowledge, the first documented case of management of a hydrogel spacer infection. The favorable treatment outcome suggests that this may be a viable treatment option for similar cases.

The prognosis for unresectable advanced gastric cancer remains poor. Chemotherapy is the primary treatment, and the recent introduction of immune checkpoint inhibitors (ICIs) has improved outcomes. Despite their benefits, ICIs can cause severe immune-related adverse events, necessitating careful administration. Conversion surgery, which involves radical resection after a positive response to chemotherapy, has shown better outcomes than chemotherapy alone. A 74-year-old woman presented with abdominal distension, and was diagnosed with advanced gastric cancer invading the transverse colon and causing obstruction. Radical resection was deemed difficult; hence, a bypass for colon obstruction was performed. Intraoperative assessments revealed transverse colon invasion, peritoneal dissemination, and positive results in lavage cytological examinations, confirming stage 4 gastric cancer. Postoperative chemotherapy with S-1, oxaliplatin, and nivolumab was initiated. She developed severe immune-related liver injury, responded to steroids, and resumed chemotherapy without nivolumab after recovery. After three cycles, significant tumor reduction and disappearance of peritoneal dissemination were observed. Conversion surgery, including right hemicolectomy and distal gastrectomy, was performed to achieve R0 resection. The patient was discharged on the ninth postoperative day and underwent adjuvant chemotherapy with S-1. She remained recurrence-free 18 months after surgery. This case demonstrated successful downstaging using chemotherapy with ICIs and subsequent radical resection via conversion surgery. Thus, conversion surgery is a viable option for multidisciplinary gastric cancer treatment and may see increased application with aggressive chemotherapy plus ICI regimens for managing metastatic or unresectable gastric cancer.

Nivolumab, a PD-1 inhibitor, enhances anti-tumor immunity but can cause immune-related adverse events (irAEs). Although irAE-colitis usually occurs within 2-3 months of starting nivolumab, we report a rare case that developed 38 months after treatment initiation. A 75-year-old man with metastatic renal cell carcinoma received multiple lines of molecular targeted therapies before starting nivolumab. After progression of bone metastases, nivolumab was reinitiated and maintained a complete response of bilateral iliac bone metastases for three years. He subsequently developed Grade 3 diarrhea. Colonoscopy revealed diffuse inflammation from rectum to sigmoid colon, and pathological examination showed findings consistent with irAE-colitis. Prompt initiation of prednisolone 60 mg/day led to complete symptom resolution within two weeks. This case represents the first reported instance of irAE-colitis occurring after 38 months of nivolumab treatment. It is essential to conduct regular follow-up examinations and actively perform diagnostic tests when symptoms arise, ensuring vigilance for the potential occurrence of delayed-onset irAEs to facilitate appropriate management.

Zolbetuximab is a monoclonal antibody targeting Claudin 18.2 that has been approved for the treatment of advanced gastric cancer in Japan. Zolbetuximab has its anticancer effects through a variety of mechanisms, including antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity. Previous studies have identified edema and hypoalbuminemia as adverse events associated with zolbetuximab treatment although the mechanisms underlying these effects remain unclear. In this report, we present a case of zolbetuximab-inducing protein-losing gastroenteropathy in a patient with advanced gastric cancer. This case demonstrated protein leakage from the upper gastrointestinal tract, confirmed through protein leakage scintigraphy. This finding could provide the mechanisms of zolbetuximab-induced edema and hypoalbuminemia.

We treated two patients with metastatic castration-resistant prostate cancer (mCRPC) who achieved a response duration of more than 12 months with Poly-ADP-ribose polymerase inhibitor (PARPi). Case 1 was a patient in his 60s with lung metastases, and case 2 was in his 70s and presented liver metastases. Genetic tests (FoundationOne^® CDx) were performed. Both patients had somatic biallelic BRCA2 loss, together with RB1 splice site variant (NM_000321.3:c.2489 + 1G > C) or RB1 loss. After PARPi administration, their metastatic sites had shrunk enough to keep partial response. These cases suggested that patients with mCRPC with biallelic BRCA2 loss and the RB1 splice site variant or loss may have remarkable response to PARPi.

The half-life of radioactive iodine (RAI) is prolonged in patients with chronic kidney disease (CKD) because RAI is mainly excreted by the kidneys. There is little information on the RAI half-life in patients with dialysis-dependent CKD (CKDG5d). Estimating the RAI half-life in a patient's body provides important information for treatment planning. In this paper, we report a 68-year-old woman of CKDG5d who underwent postsurgical RAI therapy for papillary adenocarcinoma of the thyroid. We administered 15 mCi (0.56 GBq) RAI (¹³¹I) and continuously measured the dose equivalent rate. The results were summarized into hourly values of dose equivalent rate. Based on the measurements, we estimated the RAI half-life in the patient's body using a semi-log plot and linear regression analysis. In addition, we calculated the integrated doses for caregivers and the public using coefficients of 0.5 and 0.25, respectively. The half-life in the patient's body was 7.2 days (95% confidence interval, 4.8-14.4). The integrated doses for caregivers and the public were 0.23 mSv and 0.11 mSv, respectively. RAI therapy for a CKDG5d patient should be planned on the basis of the biological dynamics of ¹³¹I. Accumulation of more cases should lead to the establishment of a treatment strategy for patients undergoing RAI therapy and hemodialysis.

A 69-year-old male presented to our clinic with bloody faecal matter. Examination revealed a 60-mm type 1 tumour on the posterior rectal wall and a 15-mm type Is tumour on the anterior rectal wall. R0 resection was performed via laparoscopic perineal rectal resection (extraperitoneal colectomy). Immunohistochemical staining led to the diagnosis of anorectal malignant peripheral nerve sheath tumour on the posterior rectal wall and anorectal malignant melanoma on the anterior rectal wall. Peritoneal dissemination occurred 10 months after resection, with the appearance of liver tumours. The liver was biopsied and pathological examination revealed metastasis due to malignant peripheral nerve sheath tumours. Primary treatment with doxorubicin plus ifosfamide and secondary treatment with etoposide plus carboplatin were ineffective.