Current problems in cancer. Case reports最新文献

英文中文

Mesonephric-like adenocarcinoma of the ovary: A rare case report and review of the literature 卵巢中肾样腺癌：一例罕见病例报告及文献复习

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-02-09 DOI: 10.1016/j.cpccr.2025.100355

Maryam Hosseinirad , Elham Mirzaeian , Amirhossein Charejoo

Mesonephric-like adenocarcinoma of the ovary is an exceedingly rare malignant tumor within the reproductive system, accounting for fewer than 1 % of all malignant tumors in women. Originating from remnants of the regressed Wolffian duct during embryonic development, its clinical manifestations are nonspecific, and its rarity often leads to delayed diagnosis, resulting in heightened morbidity and long-term recurrence. We discuss a case of 57-year-old woman with ovarian cysts that were incidentally found in abdominal and pelvic sonography and final diagnosis of mesonephric-like adenocarcinoma with peritoneal involvement and 2014 FIGO stage classification of stage IIIc which is extremely rare stage at presentation in this particular tumor. Diagnosis primarily relies on meticulous physical examination coupled with imaging, complemented by histological analysis and the tracking of diagnostic immunohistochemical markers (positive for TTF1, GATA3, PAX8, and CD10 while conversely negative for ER and PR). This study elucidates the clinical and pathophysiological attributes, diagnostic findings, and treatment strategies through the analysis of a subset of patients diagnosed with mesonephric-like adenocarcinoma in the ovary, followed by a comprehensive literature review.

卵巢中肾样腺癌是一种极为罕见的生殖系统恶性肿瘤，在女性所有恶性肿瘤中所占比例不到1%。起源于胚胎发育过程中退化的沃尔夫管残余，其临床表现无特异性，其罕见性往往导致诊断延误，导致发病率增高和长期复发率。我们讨论一例57岁女性卵巢囊肿，在腹部和盆腔超声检查中偶然发现，最终诊断为累及腹膜的肾样腺癌，2014年FIGO分期为IIIc期，这在这种特殊的肿瘤中非常罕见。诊断主要依靠细致的体格检查和影像学检查，辅以组织学分析和诊断性免疫组织化学标志物（TTF1、GATA3、PAX8和CD10阳性，ER和PR相反阴性）。本研究通过分析一小部分诊断为卵巢中肾样腺癌的患者，阐述其临床和病理生理特征、诊断结果和治疗策略，并进行全面的文献综述。

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引用次数: 0

Streptococcus gallolyticus endocarditis, a silent sign for colonic cancer: Case report and literature review 溶胆链球菌心内膜炎：结肠癌的无声征象：1例报告及文献复习

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-02-07 DOI: 10.1016/j.cpccr.2025.100354

Youssef Lahmouz, Zaynab Mouhib, Najat Mouine, Hicham Bouzelmat, Ali Chaib, Aatif Benyass

We describe the case of a 81-year-old male patient with Cardiac device-related endocarditis caused by Streptococcus gallolyticus (Sgg) and colonic adenocarcinoma with fatal neurological complications. It is important to highlight the need for thorough colon examination, even in asymptomatic individuals, when diagnosing infective endocarditis caused by Sgg.

我们报告一例81岁男性患者，由溶胆链球菌（Sgg）和结肠腺癌引起心脏装置相关心内膜炎，并伴有致命的神经系统并发症。当诊断由Sgg引起的感染性心内膜炎时，即使在无症状的个体中，也需要强调彻底的结肠检查。

引用次数: 0

Incidental encounters – unveiling neuroendocrine neoplasms in routine upper gastrointestinal endoscopy: A case series 偶然接触-揭示神经内分泌肿瘤在常规上消化道内镜：一个病例系列

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-02-06 DOI: 10.1016/j.cpccr.2025.100356

Dr. Mitali M․ Rath , Dr. Rashmi Patnayak , Dr. Shiva Dhala Mohapatra , Dr. Prakash Chandra Dalei

Introduction

Neuroendocrine neoplasms (NENs) of the gastrointestinal (GI) tract or pancreas are collectively called Gastroenteropancreatic NENs (GEP-NENs). The incidence and prevalence of these tumors is on a rise, owing to higher awareness and advanced diagnostic modalities. Many of them are incidentally detected during endoscopy or cross-sectional imaging. Here we present nine cases of GEP-NENs which were detected incidentally during their hospital visit for various GI complaints.

Method

Upper GI endoscopic biopsy was performed in 1052 patients at this single institution. Routine histopathology, and when needed, immunohistochemistry (IHC) tests were carried out. Final diagnosis of NEN was made on the basis of the 2019 WHO classification.

Result

Nine cases were histologically confirmed having NEN. The lesions were located in the duodenum in six cases and in the stomach in three. All except one were Grade 1 neuroendocrine tumors (NET), one patient had grade 2 NET. In three cases the NET was limited to mucosa and submucosal invasion was seen in six cases. Patients were managed with polypectomy(n = 2), endoscopic mucosal resection (EMR)(n = 2), endoscopic submucosal dissection (ESD)(n = 3), surgical resection(n = 1) and no therapeutic intervention, only regular follow up (n = 1)

Discussion

All polypoidal or submucosal lesions of the GI tract may be biopsied to avoid missing out GEP-NENs. New and advanced techniques of GI endoscopy play a pivotal role in diagnosis and management of GEP-NENs. Here we are sharing our experience of upper GI tract NENs at a single gastroenterology super speciality centre in Eastern India.

胃肠道或胰腺的神经内分泌肿瘤（NENs）统称为胃肠胰神经内分泌肿瘤（GEP-NENs）。由于认识的提高和先进的诊断方法，这些肿瘤的发病率和流行率正在上升。其中许多是在内窥镜检查或横断面成像时偶然发现的。在这里，我们提出了9例GEP-NENs，这些病例是在他们因各种胃肠道疾病就诊期间偶然发现的。方法对1052例患者进行内镜活检。进行常规组织病理学检查，必要时进行免疫组织化学（IHC）检查。NEN的最终诊断是根据2019年世界卫生组织的分类做出的。结果9例经组织学证实为NEN。病变位于十二指肠6例，胃3例。除1例为1级神经内分泌肿瘤外，其余均为1级神经内分泌肿瘤，1例为2级神经内分泌肿瘤。其中3例局限于粘膜，6例粘膜下浸润。患者行息肉切除术（n = 2），内镜下粘膜切除术（n = 2），内镜下粘膜剥离（n = 3），手术切除（n = 1），无治疗干预，仅定期随访（n = 1）。讨论所有胃肠道息肉样或粘膜下病变均可行活检，以避免遗漏GEP-NENs。胃肠道内窥镜的新技术和先进技术在GEP-NENs的诊断和治疗中发挥着关键作用。在这里，我们将分享我们在印度东部单一胃肠病学超级专业中心的上消化道NENs的经验。

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引用次数: 0

Oropharyngeal metastasis of merkel cell carcinoma: Case report and review of the literature 默克尔细胞癌口咽转移一例报告及文献复习

IF 0.2 Q4 ONCOLOGY

Current problems in cancer. Case reports

Pub Date : 2025-01-26 DOI: 10.1016/j.cpccr.2025.100352

John S. Howard , Trisha Wise-Draper , Kevin Redmond , Rebecca Howell , Steven D. Gilday , Dustin A. Silverman

Merkel cell carcinoma (MCC) is an aggressive neuroendocrine tumor of the skin, most commonly affecting sun exposed areas of the head and neck in older patients. Surgery remains the mainstay of treatment followed by adjuvant radiation or chemoradiation therapy in appropriately selected patients. Though MCC is associated with high rates of locoregional recurrence and propensity for distant metastases, metastatic disease involving the oropharynx is exceedingly rare; the optimal therapeutic approach in this setting remains controversial. Herein, we report a rare case of metastatic MCC to the base of tongue presenting as acute oropharyngeal hemorrhage in an 86-year-old male without an identifiable primary lesion. Definitive airway management and treatment with tumor-directed radiation and concurrent pembrolizumab were successful in this case. Optimal diagnostic and treatment strategies are discussed in addition to a review of the literature for patients with metastatic MCC affecting the oropharynx. Further, the role of transoral robotic surgery (TORS), systemic chemotherapeutic regimens, and immunotherapy in this setting are highlighted.

默克尔细胞癌（MCC）是一种侵袭性的皮肤神经内分泌肿瘤，最常见于老年患者的头颈部暴露在阳光下的区域。手术仍然是治疗的主要方式，其次是适当选择的患者的辅助放疗或放化疗。虽然MCC与高局部复发率和远处转移倾向相关，但涉及口咽部的转移性疾病极为罕见；这种情况下的最佳治疗方法仍然存在争议。在此，我们报告一例罕见的转移性MCC到舌底的病例，表现为急性口咽出血，患者为86岁男性，无可识别的原发病变。在这个病例中，肿瘤定向放疗和并发派姆单抗的最终气道管理和治疗是成功的。除了对影响口咽部的转移性MCC患者的文献进行回顾外，还讨论了最佳诊断和治疗策略。此外，经口机器人手术（TORS）、全身化疗方案和免疫治疗在这种情况下的作用被强调。

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引用次数: 0

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

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