scholarly journals Cat Scratch Disease as a Mimicker of Malignancy

Author(s):  
U Dhal ◽  
R S Hicklen ◽  
J Tarrand ◽  
D P Kontoyiannis

Abstract Cat Scratch Disease (CSD) infrequently mimics malignancy. We reviewed 11 such cases at MD Anderson Cancer Center and an additional 36 reported from the literature. Breast cancer, sarcoma, and lymphoma were the most commonly suspected malignancies. Most patients were young, female, had prior cat exposure and had no systemic symptoms. Regional lymphadenopathy was the most common finding.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S777-S777
Author(s):  
Udit Dhal ◽  
Jeffery Tarrand ◽  
Dimitrios P Kontoyiannis

Abstract Background Cat scratch disease (CSD) mimicking malignancy has been the subject of scattered case reports. To that end, we reviewed patients (pts) with CSD at MD Anderson Cancer Center (MDACC), focusing on the clinical overlap of CSD presentation with that of malignancy. Methods We retrospectively reviewed all pts diagnosed with CSD at MDACC (11/2015-1/2020). CSD was diagnosed based on Bartonella henselae serology, animal exposure and biopsy findings consistent with the diagnosis. We collected data on CSD epidemiology, signs, symptoms, laboratory findings, histopathology, radiological studies, treatment used, outcome and the malignancy mimicked. We also reviewed the published cases of CSD mimicking malignancy (1952-2020). Results We identified 11 such pts; 1 (9%) was male and 5(45%) were ≤ 18 years old. No pt had a prior history of malignancy. All but 1 pt reported an exposure to cats. Only 2/11 (18%) had fever, and none of the pts had skin lesions or hepatosplenomegaly. All pts had lymphadenopathy; 2/11 (18%) had only inguinal lymphadenopathy. PET scan was performed for 3 pts and revealed only enlarged lymph nodes. Several malignancies were considered as initial diagnostic impressions, including sarcoma (n=3), lymphoma (n=2), breast cancer (n=2). Serum Bartonella IgG titer was ≥ 1:512 in 9/11(82%) pts with 3 pts (28%) positive for IgM. 8 pts had a biopsy and non-necrotizing granuloma was the most common finding, present in 4. Azithromycin was used in all 8 pts that were treated. Nearly all pts improved or had resolution of symptoms with one pt having persistent fever and lymphadenopathy. Literature search identified 33 cases of CSD that mimicked malignancy (10 for breast cancer, 10 for lymphoma, 6 for sarcoma with 1 each for lung, pancreatic, parotid and 4 others). Conclusion Although there was a probable referral bias in the CSD pts at MDACC, CSD should be included in the differential diagnosis of malignancy. Although publication biases are probable, literature review also supports the notion that atypical CSD rarely can simulate a variety of malignancies. Disclosures Dimitrios P. Kontoyiannis, MD, Amplyx Pharmaceuticals (Consultant)Astellas Pharma (Consultant)Ciadara Therapeutics (Consultant)Gilead Sciences (Other Financial or Material Support, Honoraria)Mayne Pharma (Consultant)Merck & Co (Consultant, Honoraria)Pharma (Consultant)United Medical (Other Financial or Material Support, Honoraria)


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1072-1072
Author(s):  
Amanda Marie Parkes ◽  
Katherine Clifton ◽  
Aydah Al Awadhi ◽  
Oluchi Oke ◽  
Carla L. Warneke ◽  
...  

1072 Background: Metastatic breast cancer (MBC) pts with BOM are a unique population with limited characterization. Our goal was to characterize the TS of BOM pts, evaluating differences in sites and types of bone metastases (BM), treatment, and survival. Methods: We identified pts followed at MD Anderson Cancer Center from 01/01/1997 to 12/31/2015 for at least 6 months with a BOM diagnosis as first site of metastasis (met). TS was assessed by initial biopsy immunohistochemistry (IHC) (Table 1) with hormone receptor (HR) + defined as ER or PR >10%. Results: We identified 1445 pts with BOM, 1049 with initial biopsy IHC available to group into TS (Table 1). Among BOM pts, the majority had multiple BM at diagnosis (1141/79%), most in both the axial (Ax) and appendicular (App) skeleton (53%). Of the 808 pts with BM categorized on imaging at diagnosis, the majority were lytic (389/48%), with 21% sclerotic, 18% mixed, and 12% blastic. Time from breast cancer diagnosis to first met differed significantly by TS, χ2(3) = 94.33, P< .0001, with median time to met longer for pts with blastic (3.08 years; 95% CI 2.03, 4.24) versus lytic lesions (1.75 years; 95% CI 1.27, 2.17). Conclusions: BOM patients are a unique MBC subpopulation, more commonly found in luminal TS patients. Our study demonstrates prognostic differences in BOM pts specific to TS and emphasizes the need for further study of BOM patients. [Table: see text]


2015 ◽  
Vol 33 (10) ◽  
pp. 1119-1127 ◽  
Author(s):  
Elizabeth A. Mittendorf ◽  
Karla V. Ballman ◽  
Linda M. McCall ◽  
Min Yi ◽  
Aysegul A. Sahin ◽  
...  

Purpose The seventh edition of the American Joint Committee on Cancer (AJCC) staging system for breast cancer differentiates patients with T1 tumors and lymph node micrometastases (stage IB) from patients with T1 tumors and negative nodes (stage IA). This study was undertaken to determine the utility of the stage IB designation. Patients and Methods The following two cohorts of patients with breast cancer were identified: 3,474 patients treated at The University of Texas MD Anderson Cancer Center from 1993 to 2007 and 4,590 patients from the American College of Surgeons Oncology Group (ACOSOG) Z0010 trial. Clinicopathologic and outcomes data were recorded, and disease was staged according to the seventh edition AJCC staging system. Recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were determined using the Kaplan-Meier method and compared using the log-rank test. Results Median follow-up times were 6.1 years and 9.0 years for the MD Anderson Cancer Center and ACOSOG cohorts, respectively. In both cohorts, there were no significant differences between patients with stage IA and stage IB disease in 5- or 10-year RFS, DSS, or OS. Estrogen receptor (ER) status and grade significantly stratified patients with stage I disease with respect to RFS, DSS, and OS. Conclusion Among patients with T1 breast cancer, individuals with micrometastases and those with negative nodes have similar survival outcomes. ER status and grade are better discriminants of survival than the presence of small-volume nodal metastases. In preparing the next edition of the AJCC staging system, consideration should be given to eliminating the stage IB designation and incorporating biologic factors.


2017 ◽  
Vol 21 (02) ◽  
pp. 41-47

Merck and MD Anderson Cancer Center Enter Three-Year Strategic Collaboration. Cervical Cancer: A Preventable Disease. Consumption of Grilled Meat Linked to Higher Mortality Risk Among Breast Cancer Survivors. Prostate Cancer Team Cracks Genetic Code to Show Why Inherited Disease Can Turn Lethal. Social Interaction Can Affect Breast Cancer Outcomes. One More Piece in the Puzzle of Liver Cancer Identified. Synpromics Announces a Research Collaboration with GE Healthcare to Extend the Toolbox for Production of Biologics. Illumina and Bio-Rad Launch Solution for Single-Cell Genomic Sequencing to Enable Robust Study of Complex Diseases.


2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 49-49
Author(s):  
Miraj G. Shah-Khan ◽  
Tiffany Torstensen ◽  
Tanya L. Hoskin ◽  
Marilyn Morton ◽  
Darcy Adamczyk ◽  
...  

49 Background: Predicting nodal positivity can guide surgical planning in breast cancer. Memorial Sloan-Kettering Cancer Center (MSKCC) and MD Anderson Cancer Center (MDACC) have established nomograms to predict sentinel node positivity. We propose that addition of distance of tumor from the nipple (DFN) can improve their performance. Methods: With IRB approval clinical T1/T2 tumors with pre-biopsy ultrasound were reviewed. MSKCC and MDACC nomogram predictions and the AUC-ROC were calculated. The addition of DFN was examined using multiple logistic regression and comparison of AUC-ROC values. Results: 401 breast cancers with clinical T1 (85%) or T2 (15%) tumors in 395 patients were included; of which 79/401 (19.7%) were node positive. Tumors were significantly closer to the nipple in those with positive nodes. 17/33 (51.5%) tumors within 2 cm of the nipple were node-positive versus 62/368 (16.8%) tumors > 2 cm from the nipple (p<0.0001). The MSKCC and MDACC nomograms each demonstrated good discrimination between node positive and negative patients with AUC-ROC values of 0.71 (95% CI: 0.64-0.77) and 0.74 (95% CI: 0.68-0.81), respectively. When added to the MSKCC nomogram, DFN ≤2 cm contributed significantly (OR 4.78, p=0.0001) to prediction of node positivity and improved the AUC-ROC to 0.73 (95% CI: 0.67-0.80). Similarly, DFN ≤2 cm was significant (OR 4.73, p=0.0002) when added to the MDACC nomogram and improved the AUC to 0.76 (95% CI: 0.70-0.82). Within nomogram probability categories, the proportion with positive nodes was consistently higher with DFN ≤2 cm. Conclusions: Tumor distance from nipple is associated with nodal positivity. When added to nomograms it improves prediction of node positivity. DFN should be considered when considering likelihood of nodal positivity for treatment planning. [Table: see text]


2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 1046-1046
Author(s):  
Diogo Bugano Diniz Gomes ◽  
Rita Elias Deeba ◽  
Dima Suki ◽  
Vicente Valero ◽  
Stacy L. Moulder ◽  
...  

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