Treatment-induced sarcoidosis in a patient with metastatic clear cell ovarian cancer

2021 ◽  
Vol 14 (12) ◽  
pp. e247278
Author(s):  
Kathryn DeCarli ◽  
Rebecca Masel ◽  
Andrew Hsu ◽  
Mary Lopresti
Keyword(s):  
Ovarian Cancer ◽  
Clinical Presentation ◽  
Clear Cell ◽  
Symptomatic Improvement ◽  
Definitive Treatment ◽  
Mediastinal Lymphadenopathy ◽  
Granulomatous Disease ◽  
Antineoplastic Treatment ◽  
Investigational Agents ◽  
Variable Clinical Presentation

Sarcoidosis is a granulomatous disease that commonly presents with lung or lymphatic system manifestations. Diagnosis is often delayed due to variable clinical presentation. This is a case of a patient with metastatic clear cell ovarian cancer who developed disease reoccurence after definitive treatment with surgery and adjuvant chemotherapy. She was treated with multiple lines of therapy, including investigational agents. During this time, she developed mediastinal lymphadenopathy and hypercalcaemia. Due to suspicion that her presentation was not a manifestation of her malignancy, she underwent two lymph node biopsies revealing granulomatous disease. She was initiated on prednisone for management of sarcoidosis, which led to radiologic, laboratory and symptomatic improvement. Although the precipitating factor for this patient’s sarcoidosis cannot be definitively determined, nivolumab is a possible culprit. This case highlights the importance of a broad differential diagnosis when a patient undergoing antineoplastic treatment develops mediastinal lymphadenopathy or hypercalcaemia.

scholarly journals Youssef’s Syndrome following Cesarean Section

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ozer Birge ◽  
Ertugrul Gazi Ozbey ◽  
Mustafa Melih Erkan ◽  
Deniz Arslan ◽  
Ilkan Kayar
Keyword(s):  
Urinary Incontinence ◽  
Cesarean Section ◽  
Diagnostic Tests ◽  
Vaginal Bleeding ◽  
Clinical Presentation ◽  
Definitive Treatment ◽  
Lower Segment ◽  
Vesicouterine Fistula ◽  
Lower Segment Cesarean Section ◽  
Variable Clinical Presentation

Youssef’s syndrome is characterized by cyclic hematuria (menouria), absence of vaginal bleeding (amenorrhea), and urinary incontinence due to vesicouterine fistula (VUF), the least common of the urogynecological fistulas. Youssef’s syndrome has a variable clinical presentation. A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The most common cause is lower segment Cesarean section. Conservative treatment may be appropriate in some cases, but surgery is the definitive treatment. Vesicouterine fistula should be suspected in cases presenting with urinary incontinence even years after Cesarean section. Diagnostic tests as well as necessary appropriate surgery should be performed on cases with suspected vesicouterine fistula. We present a 40-year-old multiparous woman with vesicouterine fistula after primary Cesarean section; she presented with urinary incontinence, hematuria, and amenorrhea 1 year after the birth. Here, we discuss our case with the help of previously published studies found in the literature.

scholarly journals Frequent PIK3CA mutations in eutopic endometrium of patients with ovarian clear cell carcinoma

2021 ◽  
Author(s):  
Kosuke Murakami ◽  
Akiko Kanto ◽  
Kazuko Sakai ◽  
Chiho Miyagawa ◽  
Hisamitsu Takaya ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Driver Mutations ◽  
Intratumor Heterogeneity ◽  
Ovarian Clear Cell Carcinoma ◽  
Eutopic Endometrium ◽  
Stromal Component ◽  
Hotspot Mutations

AbstractRecent studies have reported cancer-associated mutations in normal endometrium. Mutations in eutopic endometrium may lead to endometriosis and endometriosis-associated ovarian cancer. We investigated PIK3CA mutations (PIK3CAm) for three hotspots (E542K, E545K, H1047R) in eutopic endometrium in patients with ovarian cancer and endometriosis from formalin-fixed paraffin-embedded specimens by laser-capture microdissection and droplet digital PCR. The presence of PIK3CAm in eutopic endometrial glands with mutant allele frequency ≥ 15% were as follows: ovarian clear cell carcinoma (OCCC) with PIK3CAm in tumors, 20/300 hotspots in 11/14 cases; OCCC without PIK3CAm, 42/78 hotspots in 11/12 cases; high-grade serous ovarian carcinoma, 8/45 hotspots in 3/5 cases; and endometriotic cysts, 5/63 hotspots in 5/6 cases. These rates were more frequent than in noncancer nonendometriosis controls (7/309 hotspots in 5/17 cases). In OCCC without PIK3CAm, 7/12 (58%) cases showed multiple hotspot mutations in the same eutopic endometrial glands. In 3/54 (5.6%) cases, PIK3CAm was found in eutopic endometrial stroma. Multisampling of the OCCC tumors with PIK3CAm showed intratumor heterogeneity in three of eight cases. In two cases, PIK3CAm was detected in the stromal component of the tumor. Homogenous PIK3CAm in the epithelial component of the tumor matched the mutation in eutopic endometrial glands in only one case. Eutopic endometrial glands in ovarian cancer and endometriosis show high frequency of PIK3CAm that is not consistent with tumors, and multiple hotspot mutations are often found in the same glands. While the mutations identified in eutopic endometrium may not be driver mutations in the patient’s cancer, these are still driver mutations but this specific clone has not undergone the requisite steps for the development of cancer.

scholarly journals Biallelic MCM3AP mutations cause Charcot-Marie-Tooth neuropathy with variable clinical presentation

Brain ◽  
2017 ◽  
Vol 140 (10) ◽  
pp. e65-e65 ◽  
Author(s):  
Mert Karakaya ◽  
Neda Mazaheri ◽  
Ipek Polat ◽  
Diana Bharucha-Goebel ◽  
Sandra Donkervoort ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Charcot Marie Tooth ◽  
Variable Clinical Presentation

Differential expression of ABCF2 protein among different histologic types of epithelial ovarian cancer and in clear cell adenocarcinomas of different organs

2007 ◽  
Vol 38 (1) ◽  
pp. 134-139 ◽  
Author(s):  
Sadako Nishimura ◽  
Hiroshi Tsuda ◽  
Kiyoshi Ito ◽  
Toshiko Jobo ◽  
Nobuo Yaegashi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Differential Expression ◽  
Clear Cell ◽  
Histologic Types

Sarcoidosis Presenting as Nasal Obstruction

1993 ◽  
Vol 7 (3) ◽  
pp. 133-138 ◽  
Author(s):  
Mark J. Shikowitz ◽  
Aijaz Alvi
Keyword(s):  
Respiratory Tract ◽  
Nasal Obstruction ◽  
Clinical Presentation ◽  
Multiple Organ ◽  
Diagnostic Workup ◽  
Unknown Etiology ◽  
Granulomatous Disease ◽  
Upper Respiratory Tract ◽  
Important Symptom ◽  
Upper Respiratory

Sarcoidosis is a chronic systemic granulomatous disease of unknown etiology. The histology of this disease was first reported by Boeck in 1899. Since that time many reports of multiple organ involvement have been published. Symptoms relating to the upper respiratory tract are not uncommon. Nasal obstruction as the presenting and primary complaint in sarcoidosis however is a rare but important symptom as it may lead to the diagnosis of this treatable disease. We present three patients whose initial complaint of progressive nasal obstruction heralded the diagnosis of sarcoidosis upon further workup. The clinical presentation, diagnostic workup, histology, and management of nasal sarcoidosis are discussed.

Methionine Synthase Deficiency: Variable Clinical Presentation And Benefit Of Early Diagnosis And Treatment

2021 ◽  
Author(s):  
Kimberly A. Kripps ◽  
Leighann Sremba ◽  
Austin A. Larson ◽  
Johan L.K. Van Hove ◽  
Hoanh Nguyen ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Clinical Presentation ◽  
Methionine Synthase ◽  
Diagnosis And Treatment ◽  
Variable Clinical Presentation

scholarly journals Occult Liver Abscess Following Clinically Unsuspected Ingestion of Foreign Bodies

1997 ◽  
Vol 11 (5) ◽  
pp. 445-448 ◽  
Author(s):  
Ban CH Tsui ◽  
J Mossey
Keyword(s):  
Foreign Body ◽  
Preoperative Diagnosis ◽  
Foreign Bodies ◽  
Clinical Presentation ◽  
Computed Tomographic ◽  
Liver Abscesses ◽  
Computed Tomographic Scan ◽  
History Of ◽  
Variable Clinical Presentation

Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gut with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively. This report emphasizes the role of ultrasound and computed tomographic scan in evaluating similar cases. Any patient with known risk factors for ingestion of foreign body should arouse suspicion and be investigated further.

Protein expression levels of excision repair cross-complementation group 1 and xeroderma pigmentosum D correlate with response to platinum-based chemotherapy in the patients with advanced epithelial ovarian cancer

2008 ◽  
Vol 18 (5) ◽  
pp. 1007-1012 ◽  
Author(s):  
K. Lin ◽  
D. Ye ◽  
X. Xie
Keyword(s):  
Ovarian Cancer ◽  
Protein Expression ◽  
Clear Cell ◽  
Excision Repair ◽  
Cell Cancer ◽  
Complementation Group ◽  
Serous Ovarian Cancer ◽  
Expression Levels ◽  
Platinum Based Chemotherapy ◽  
Group 1

This study was undertaken to examine whether there is an association between excision repair cross-complementation group 1 (ERCC1) and xeroderma pigmentosum D (XPD) protein expression levels and response to platinum-based chemotherapy in epithelial ovarian cancer (EOC). The study cohort consisted of 91 consecutive patients suffering from stage III or IV disease of primary EOC from 1999 to 2004 at the Women's Hospital, School of Medicine, Zhejiang University. There were 36 sensitive cases of serous ovarian cancer, 27 resistant cases of serous ovarian cancer, 15 cases of clear cell cancer, and 13 cases with serous ovarian cancer receiving neoadjuvant chemotherapy. The ovarian tissue microsections were stained by standard immunohistochemical techniques to show ERCC1 and XPD protein expression levels. In resistance group of serous ovarian cancer, ERCC1 and XPD protein expression levels were significantly higher than those of sensitivity group, and after receiving neoadjuvant chemotherapy, they showed 23% and 32% higher than before. Meanwhile, their levels of clear cell cancer group were significantly higher than serous ovarian cancer group's. Upregulation of ERCC1 and XPD protein expression was associated with resistance process to platinum-based chemotherapy in advanced EOC. This study provided evidence that differences of nucleotide excision repair–related genes expression may have an effect on the observed differences in clinical behavior of EOC

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