Current problems in cancer. Case reports最新文献

英文中文

Obscure pulmonary artery intimal sarcoma presenting with hemoptysis and pulmonary embolism 隐蔽性肺动脉内膜肉瘤，表现为咯血和肺栓塞

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-01-13 DOI: 10.1016/j.cpccr.2025.100351

Daniel Cheah , Rachael Wong , Sushan Gupta , Frank Bellafiore , Paramesh Dakshinesh

Pulmonary artery intimal sarcoma (PAIS) is a rare and highly malignant neoplasm that presents similarly to pulmonary embolism. Due to the rarity of presentation and high mortality, there is limited data on its heterogeneous presentation, epidemiology, and treatment. We present a case of pulmonary artery intimal sarcoma mimicking features of pneumonia and pulmonary embolism. Our patient was a 43-year-old non-smoker male with no past medical history who presented with a cough with hemoptysis. Initial CT imaging showed acute right pulmonary embolism with right lung pulmonary infarct. The patient was treated with anticoagulation. On follow-up, he continued to complain of hemoptysis. Repeat CT lung now showed a moderate-sized right hilar mass. Endobronchial ultrasound-guided fine needle aspiration biopsy of the hilar mass with bronchial lavage showed malignant cells with immunohistochemistry positive for vimentin. The patient underwent a right pneumonectomy when he was later diagnosed with pulmonary artery intimal sarcoma. He was subsequently started on epirubicin, ifosfamide, and mesna and is currently on 3-monthly CT surveillance with no disease recurrence.

肺动脉内膜肉瘤（PAIS）是一种罕见的高度恶性肿瘤，其表现与肺栓塞相似。由于罕见的表现和高死亡率，关于其异质性表现、流行病学和治疗的数据有限。我们报告一例肺动脉内膜肉瘤，其特征与肺炎及肺栓塞相似。我们的病人是一名43岁的非吸烟男性，无既往病史，表现为咳嗽和咯血。初步CT表现为急性右肺栓塞伴右肺梗死。病人接受了抗凝治疗。在随访中，他继续抱怨咯血。重复CT示右肺门中等大小肿块。超声引导下支气管肺门肿块细针穿刺活检经支气管灌洗显示恶性细胞，免疫组化波形蛋白阳性。当他后来被诊断为肺动脉内膜肉瘤时，接受了右侧全肺切除术。随后开始使用表柔比星、异环磷酰胺和mesna，目前正在进行3个月的CT监测，无疾病复发。

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引用次数: 0

Long term efficacy and safety of Lorlatinib in ALK-positive non-small cell lung cancer: A case report Lorlatinib治疗alk阳性非小细胞肺癌的长期疗效和安全性：1例报告

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-01-11 DOI: 10.1016/j.cpccr.2025.100349

Jialin Qian, Tianqing Chu

Background

Anaplastic lymphoma kinase (ALK) rearrangement is a key oncogenic driver promoting the expression of ALK protein in non-small cell lung cancer (NSCLC). ALK tyrosine kinase inhibitors (TKIs) have significantly improved survival benefits. Exploring the optimal therapeutic regimens for ALK+ NSCLC patients is of crucial clinical significance.

Case description

A 67-year-old woman with no history of smoking was diagnosed with locally advanced ALK+ lung adenocarcinoma (stage IIIC) at the first diagnosis. The patient was enrolled in the CROWN study and was randomized to receive lorlatinib treatment, and the re-examination 1 month later showed that the lung lesions were significantly reduced. The efficacy was PR, and the PFS had reached 72 months at the last follow-up. During the treatment, the patient tolerated well, no serious adverse events occurred, and the tumor was effectively controlled.

Conclusions

Lorlatinib is an effective 1 L treatment option for patient with advanced ALK-positive NSCLC, which can bring long-term benefits to patients.

肿瘤淋巴瘤激酶（ALK）重排是促进非小细胞肺癌（NSCLC）中ALK蛋白表达的关键致癌驱动因素。ALK酪氨酸激酶抑制剂（TKIs）显著提高了生存效益。探索ALK+ NSCLC患者的最佳治疗方案具有重要的临床意义。病例描述：一名67岁女性，无吸烟史，首次诊断为局部晚期ALK+肺腺癌（IIIC期）。患者入组CROWN研究，随机接受氯拉替尼治疗，1个月后复查肺部病变明显减轻。疗效为PR，末次随访时PFS达72个月。治疗期间患者耐受性良好，未发生严重不良事件，肿瘤得到有效控制。结论索拉替尼是晚期alk阳性NSCLC患者有效的1 L治疗方案，可为患者带来长期获益。

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引用次数: 0

Review of outcomes in a veteran treated with lurbinectedin long-term for extensive-stage small cell lung cancer: A case report 长期使用鲁比丁治疗广泛期小细胞肺癌的退伍军人的疗效回顾：1例报告

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-01-10 DOI: 10.1016/j.cpccr.2025.100350

Jana Sawyer , Megan Banaszynski , Brian Do , Jesse Cobell

Small cell lung cancer comprises approximately 10% to 15% of all lung cancers but is associated with a high proliferation rate and poor prognosis. Treatment options for patients with small cell lung cancer have been limited and offer modest clinical benefit. Lurbinectedin, an approved treatment by the United States Food and Drug Administration for metastatic small cell lung cancer in adults with disease progression during or after platinum-based chemotherapy, was shown to have antitumor activity and a favorable safety profile in a phase II trial. Here, we present a case report of a patient who was treated with lurbinectedin for approximately 2 years and maintained stable disease while receiving a reduced dose. The patient developed grade 3 anemia which resolved following a dose reduction of lurbinectedin, allowing for mitigation of toxicity while maintaining the clinical efficacy of the drug. Clinicians who treat patients with small cell lung cancer should be aware of this extended use of lurbinectedin in a patient who relapsed following first-line treatment and maintained stable disease on a reduced dose for almost 2 years.

小细胞肺癌约占所有肺癌的10%至15%，但与高增殖率和预后差有关。小细胞肺癌患者的治疗选择有限，临床获益有限。Lurbinectedin是美国食品和药物管理局批准的用于在铂基化疗期间或之后疾病进展的成人转移性小细胞肺癌的治疗药物，在II期试验中显示出抗肿瘤活性和良好的安全性。在这里，我们提出一个病例报告，患者接受鲁比奈定治疗约2年，并在接受减量治疗时保持疾病稳定。患者出现3级贫血，在减少鲁比粘连丁剂量后消退，允许减轻毒性，同时保持药物的临床疗效。治疗小细胞肺癌患者的临床医生应该意识到，在一线治疗后复发并在减少剂量后保持病情稳定近2年的患者中延长使用鲁比奈定。

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引用次数: 0

mTOR inhibition with sirolimus is associated with a durable response in HIV associated multifocal Epstein-Barr Virus associated smooth muscle Tumour (EBV-SMT) and mini review of novel therapeutic options 西罗莫司抑制mTOR与HIV相关多灶性eb病毒相关平滑肌肿瘤（EBV-SMT）的持久应答相关，并对新治疗方案进行了综述

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-01-09 DOI: 10.1016/j.cpccr.2024.100344

John Kh Ang , Daniel Ry Yap , Khoon Leong Chuah , Jens Samol

Epstein-Barr Virus associated smooth muscle tumour (EBV-SMT) is a rare tumour with an estimated prevalence of <2 cases per million. It develops in patients who are immunocompromised and in whom the risk of EBV reactivation causing tumorigenesis is high. Examples of immunocompromised states include patients infected with human immunodeficiency virus (HIV), patients on iatrogenic immunosuppression following transplantation and patients with primary/congenital immunodeficiency. Although the association between EBV and development of EBV-SMT is well established, the underlying pathophysiology for this association is unclear.

We present a case of a patient with HIV related EBV-SMT who has been on treatment with sirolimus for >5 years with disease continuing to remain controlled, clearly demonstrating the durable activity of sirolimus in the management of EBV-SMT. We scrutinized the literature pertaining to novel therapeutics which have been used for the management of EBV-SMTs and set it into context with other EBV associated neoplasms.

To our knowledge, this is the first case report of a patient treated with sirolimus and we recommend that mTOR inhibition with sirolimus be considered as a first therapeutic option together with HAART in patients with HIV associated EBV-SMTs.

eb病毒相关的平滑肌肿瘤（EBV-SMT）是一种罕见的肿瘤，估计患病率为百万分之2。它发生在免疫功能低下和EBV再激活导致肿瘤发生的风险高的患者中。免疫功能低下状态的例子包括感染人类免疫缺陷病毒（HIV）的患者、移植后接受医源性免疫抑制的患者和原发性/先天性免疫缺陷患者。尽管EBV和EBV- smt之间的联系已经确立，但这种联系的潜在病理生理机制尚不清楚。我们报告了一例与HIV相关的EBV-SMT患者，他已接受西罗莫司治疗5年，病情持续得到控制，清楚地证明了西罗莫司在EBV-SMT治疗中的持久活性。我们仔细审查了有关用于EBV- smt管理的新疗法的文献，并将其与其他EBV相关肿瘤联系起来。据我们所知，这是首例西罗莫司治疗患者的病例报告，我们建议将西罗莫司抑制mTOR与HAART一起作为HIV相关ebv - smt患者的第一治疗选择。

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引用次数: 0

Early onset venous and arterial thrombosis when combining Osimertinib and Amivantamab in NSCLC: Instructive cases and literature review 奥西替尼和阿米万他单联合治疗NSCLC早期静脉和动脉血栓形成：有指导意义的病例和文献综述

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-01-01 DOI: 10.1016/j.cpccr.2024.100348

Alexander S Watson, Tejas Patil, Erin L Schenk, D Ross Camidge

The bispecific antibody amivantamab has evidence in multiple combinations and indications for treating advanced Epidermal Growth Factor Receptor (EGFR) mutated NSCLC, including a recently approved first line combination with the third-generation EGFR tyrosine kinase inhibitor (TKI) lazertinib. Thrombotic complications have been reported at elevated rates for amivantamab-lazertinib combinations in clinical trials. While awaiting lazertinib approval, the previously established third-generation EGFR TKI osimertinib has been utilized by some clinicians in combinations with amivantamab, and this substitution will likely continue to be used in certain clinical contexts. Whether osimertinib-amivantamab combinations also carry thrombotic risk has not been described. Here, we outline three patient cases from our institution where osimertinib-amivantamab combinations were employed, highlighting early development of venous thromboembolism, arterial thrombosis, and use of anticoagulation prophylaxis. We review these cases in the context of the existing literature exploring thrombotic complications with amivantamab combinations. Clinicians should be aware of, discuss with patients, and take steps to mitigate, thrombotic risk with amivantamab-EGFR TKI combination therapy.

双特异性抗体amivantamab有治疗晚期表皮生长因子受体（EGFR）突变的NSCLC的多种组合和适应症的证据，包括最近批准的与第三代EGFR酪氨酸激酶抑制剂（TKI） lazertinib的一线联合。据报道，在临床试验中，阿米万他单-拉泽替尼联合用药的血栓性并发症发生率升高。在等待lazertinib批准的同时，一些临床医生已经将先前确定的第三代EGFR TKI osimertinib与amivantamab联合使用，并且这种替代可能会在某些临床情况下继续使用。奥西替尼-阿米万他单联合用药是否也有血栓形成的危险尚未报道。在这里，我们概述了来自我们机构的三例患者病例，其中使用了奥西替尼-阿米万他抗联合治疗，突出了静脉血栓栓塞、动脉血栓形成的早期发展和抗凝预防的使用。我们回顾这些病例的背景下，现有的文献探讨血栓性并发症与阿米万他单抗联合。临床医生应该意识到，与患者讨论，并采取措施减轻阿米万他单- egfr TKI联合治疗的血栓形成风险。

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引用次数: 0

Transformation of PSMA-avid to FDG-avid disease in metastatic castration-resistant prostate cancer in the setting of biochemical response with LU177-PSMA-617 LU177-PSMA-617在转移性去势抵抗前列腺癌中PSMA-avid向FDG-avid转变的生化反应

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2024-12-31 DOI: 10.1016/j.cpccr.2024.100347

A Sidhu , P Singh

引用次数: 0

A case of opsoclonus-myoclonus syndrome associated with breast cancer 阵挛-肌阵挛综合征合并乳腺癌1例

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2024-12-19 DOI: 10.1016/j.cpccr.2024.100346

Sebastian Mohar , Naomi Fujioka , Todd Tuttle , Bruce Trautman , Emilian Racila , Jianling Yuan , Sean J. Pittock , David A. Potter

Opsoclonus-myoclonus syndrome (OMS) is a rare presenting complication of cancer that is thought to be related to autoimmune mediated perturbation of homeostasis of oculomotor and limb movement. Symptoms can include arrhythmic conjugate saccades of the eyes without interval and involuntary movements of the limbs. The patient was a 56-year-old woman with OMS and an occult axillary cT0N1M0 triple negative breast cancer (TNBC). She had negative serum and CSF serology. She was initially treated with steroids and immune globulin and then neoadjuvant chemotherapy. She underwent surgical excision and radiation. At 9 years the patient is without recurrence of OMS or TNBC.

眼阵挛-肌阵挛综合征（OMS）是一种罕见的癌症并发症，被认为与自身免疫介导的动眼肌和肢体运动稳态紊乱有关。症状包括无间隔的无节律性共轭扫视和肢体不自主运动。患者是一名56岁女性，患有OMS和隐匿性腋窝cT0N1M0三阴性乳腺癌（TNBC）。血清和脑脊液血清学均为阴性。她最初接受类固醇和免疫球蛋白治疗，然后接受新辅助化疗。她接受了手术切除和放疗。9年患者无OMS或TNBC复发。

引用次数: 0

Olanzapine-induced hypertriglyceridemia in cancer care: A silent metabolic risk 癌症治疗中奥氮平诱导的高甘油三酯血症：一种沉默的代谢风险

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2024-12-18 DOI: 10.1016/j.cpccr.2024.100345

Bilal Kazi , Imaan Rumani , Marzooka Nazim Chishti Kazi , Prashant Manohar Gaikwad

Olanzapine (Zyprexa), an atypical antipsychotic, is used off-label for managing nausea in advanced cancer patients but is linked to severe metabolic side effects, including hypertriglyceridemia. This case involves a metastatic gastric carcinoma patient with no known metabolic disorder who developed critically elevated triglycerides (2898 mg/dL) after starting olanzapine for nausea. Her lipid levels significantly improved with medical management, allowing her to proceed for apheresis for the planned CAR-T treatment. This case underscores the need for vigilant metabolic monitoring in patients on Olanzapine (Zyprexa), even those without known risk factors, to prevent serious complications.

奥氮平（再普乐）是一种非典型抗精神病药物，经核准后用于治疗晚期癌症患者的恶心，但与严重的代谢副作用有关，包括高甘油三酯血症。本病例涉及一名转移性胃癌患者，无已知代谢紊乱，在开始使用奥氮平治疗恶心后出现甘油三酯严重升高（2898 mg/dL）。在医疗管理下，她的血脂水平显著改善，允许她继续进行计划中的CAR-T治疗的血液分离。本病例强调了对使用奥氮平（再普乐）的患者进行警惕的代谢监测的必要性，即使是那些没有已知危险因素的患者，也要预防严重的并发症。

引用次数: 0

Pleural mesothelioma: Long-term progression-free survival with Tumor Treating Fields (TTFields) therapy case reports 胸膜间皮瘤：长期无进展生存与肿瘤治疗领域（TTFields）治疗病例报告

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2024-11-30 DOI: 10.1016/j.cpccr.2024.100342

Giovanni Luca Ceresoli , Laura Mannarino , Lara Paracchini , Federica Grosso

引用次数: 0

Excellent response of cetuximab plus chemotherapy after pembrolizumab monotherapy in metastatic hypopharyngeal cancer: A case report 西妥昔单抗联合化疗在派姆单抗单药治疗转移性下咽癌后的极好疗效：1例报告

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2024-11-28 DOI: 10.1016/j.cpccr.2024.100338

Anh Tuan Pham , Thang Huu Nguyen , Thai Hong Le , Toan Khanh Phan , Anh Phuong Nguyen , Ngoc Minh Le , Thao Thu Vu

Patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) typically have an unfavorable prognosis, with a median survival of only 6 to 15 months in most studies. In cases other than local relapse or oligometastases, systemic therapy plays the dominant role. The choice of regimen is influenced by multiple clinical factors, including patient comorbidities, performance status, previous therapy, and pathologic features. We present a case of PD-L1 (programmed death-ligand 1)-negative metastatic hypopharyngeal cancer successfully treated with pembrolizumab monotherapy, followed by cetuximab combined with chemotherapy. Remarkably, the patient currently remains in good health, with no signs of disease on imaging at 35 months after diagnosis. We emphasized the importance of a well-devised treatment strategy, as well as the significant synergistic effects of the sequence in which the cetuximab-based regimen follows immune checkpoint inhibitors.

复发或转移性头颈部鳞状细胞癌（HNSCC）患者通常预后不良，大多数研究中位生存期仅为6至15个月。除局部复发或少转移外，全身治疗起主导作用。方案的选择受多种临床因素的影响，包括患者合并症、运动状态、既往治疗和病理特征。我们报告了一例PD-L1（程序性死亡配体1）阴性的转移性下咽癌，通过派姆单抗单药治疗成功，随后西妥昔单抗联合化疗。值得注意的是，患者目前身体状况良好，在诊断后35个月的影像学检查中没有任何疾病迹象。我们强调了精心设计的治疗策略的重要性，以及基于西妥昔单抗的方案在免疫检查点抑制剂之后的序列的显著协同效应。

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引用次数: 0

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