scholarly journals Corneal Perforation during Combination Chemotherapy including Cetuximab in a Patient with a History of Herpetic Keratitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Keiichi Aomatsu ◽  
Koji Sugioka ◽  
Aya Kodama-Takahashi ◽  
Masahiko Fukuda ◽  
Hiroshi Mishima ◽  
...  

Purpose. To report a case of corneal perforation, in a patient with a history of herpetic keratitis, during combination chemotherapy including cetuximab. Case. We report the case of a 71-year-old man who was diagnosed with a hypopharyngeal carcinoma and received radiation therapy combined with cetuximab, the epidermal growth factor receptor (EGFR) inhibitor monoclonal antibody. He was referred to us because of ocular hyperemia and corneal perforation in his left eye. In spite of conservative therapy, his corneal perforation was exacerbated, with iris incarceration into the wound site and exposure to the surface of the cornea. He therefore discontinued treatment with the combination chemotherapy and underwent lamellar keratoplasty using a preserved donor cornea. After treatment with cetuximab resumed, there was no recurrence of the corneal perforation. Conclusion. We have presented the first case of cetuximab-related corneal perforation in a patient who had a history of recurrent herpetic keratitis. EGFR inhibitors, such as cetuximab, can induce corneal perforation in cases with a history of herpetic stromal keratitis.

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Masataka Matsumoto ◽  
Kazumi Kaneshiro ◽  
Kiyonobu Takatsuki

Abstract Background Xeroderma pigmentosum is a rare, autosomal-recessive photosensitive dermatosis. Patients with xeroderma pigmentosum have an impaired ability to repair deoxyribonucleic acid damage caused by ultraviolet rays, resulting in skin cancer. Patients with xeroderma pigmentosum are more susceptible to some cancers. We herein report a case of xeroderma pigmentosum accompanied by lung cancer. Case presentation The patient was a Japanese woman in her 70s with a family history of consanguineous marriage. Her medical history included squamous cell carcinoma and basal cell carcinoma, in addition to xeroderma pigmentosum. She presented with dry skin with small, pigmented spots, which were particularly focused around the areas exposed to sunlight. Chest computed tomography was conducted to assess for any evidence of metastatic skin carcinoma, and revealed a tumor in the left upper subpleural lobe of the lung. Consequently, she was referred to our department. Finally, we diagnosed lung adenocarcinoma (pT2aN0M1b: stage IVA). She had an epidermal growth factor receptor (EGFR) mutation (p.L858R). Treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (gefitinib) was initiated, and the tumor gradually regressed. No side effects were observed. However, she later died from aspiration pneumonia. Conclusions Although xeroderma pigmentosum is rare, a history of consanguineous marriage should be verified. Because of the severe side effects of cisplatin and radiotherapy in xeroderma pigmentosum patients, the risks and benefits of treatment should be considered thoroughly.


2018 ◽  
Vol 11 (3) ◽  
pp. 835-841 ◽  
Author(s):  
Yohei Arihara ◽  
Kazuyuki Murase ◽  
Kohichi Takada ◽  
Naotaka Hayasaka ◽  
Shogo Miura ◽  
...  

Background: Carcinoma ex pleomorphic adenoma (CXPA) is a rare histologic subtype of lacrimal gland and submandibular gland cancer. Currently, there is no standard treatment for metastatic CXPA, although some case reports have explored the role of targeted agents in chemotherapy. A few histopathologic analyses have shown that some of these tumors overexpress human epidermal growth factor receptor-2 (HER2), suggesting a potential role for HER2-based therapy. We report here two cases of metastatic CXPA that were treated with trastuzumab-based chemotherapy (IRB approved) with rapid and significant responses. Case Report 1: A 66-year-old male was diagnosed as HER2-positive CXPA of the right lacrimal gland with multiple bone and lymph node metastases. Combination chemotherapy with trastuzumab (Tmab) and nanoparticle albumin-bound paclitaxel (nabPTX) was initiated. A rapid response was confirmed, and after seven cycles of treatment, CR(complete response) was achieved. Case Report 2: A 67-year-old female was diagnosed with HER2 positive CXPA of the right submandibular gland. Multiple pulmonary metastatic lesions were detected after surgery, and combination chemotherapy with Tmab and nab-PTX was initiated. A rapid partial response (PR) was confirmed, and she eventually became disease-free. Conclusion: In the absence of definitive clinical trials, which are unlikely to be performed due to the rarity of HER2-positive CXPA, therapeutic information must be obtained from case reports. Some reports, such as this one, have suggested a potential utility of trastuzumab-based chemotherapy.


2020 ◽  
pp. 112067212095830
Author(s):  
Mengwei Li ◽  
Jun Xiang ◽  
Chaoran Zhang

Introduction: To report the first case of severe corneal complications in a patient with Sjögren syndrome after receiving erlotinib treatment. Case description: A 51-year-old woman with Sjögren syndrome presented with persistent corneal epithelial defects, which did not respond to conservative therapies. She had been diagnosed with lung cancer and was being treated with erlotinib, a kind of epidermal growth factor receptor (EGFR) inhibitor, for over 2 years. Cornea stromal melting and perforation were not avoided and a total of four penetrating keratoplasties were performed. Stable corneal surface was achieved after the erlotinib treatment was paused. Conclusion: This report, to the best of our knowledge, is the first description of severe ocular complications present in a patient with Sjögren syndrome after receiving the EGFR inhibitor. The underlying ocular or system diseases that were thought to be irrelevant upon receiving the EGFR inhibitors might negatively influence the tumor patients planning to take these kinds of targeted medication. Therefore, it is important to have eye examinations before and during the EGFR inhibitors treatment and supplement the relative contraindications (such as Sjögren syndrome) to EGFR inhibitor treatments as necessary.


2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Enrique O. Graue-Hernandez ◽  
Isaac Zuñiga-Gonzalez ◽  
Julio C. Hernandez-Camarena ◽  
Martha Jaimes ◽  
Patricia Chirinos-Saldaña ◽  
...  

Purpose. To report a case of severe corneal thinning secondary to dry eye treated with a tectonic Descemet stripping automated lamellar keratoplasty (DSAEK) and amniotic membrane graft.Methods. A 72-year-old man with a history of long standing diabetes mellitus type 2 and dry eye presented with 80% corneal thinning and edema on the right eye and no signs of infectious disease, initially managed with topical unpreserved lubrication and 20% autologous serum drops. Eight weeks after, the defect advanced in size and depth until Descemetocele was formed. Thereafter, he underwent DSAEK for tectonic purposes. One month after the procedure, the posterior lamellar graft was well adhered but a 4 mm epithelial defect was still present. A multilayered amniotic membrane graft was then performed.Results. Ocular surface healed quickly and reepithelization occurred over a 2-week period. Eight months after, the ocular surface remained stable and structurally adequate.Conclusion. Tectonic DSAEK in conjunction with multilayered amniotic graft may not only provide structural support and avoid corneal perforation, but may also promote reepithelization and ocular surface healing and decrease concomitant inflammation.


2021 ◽  
Vol 84 (2) ◽  
pp. 379-380
Author(s):  
M Mascarenhas Saraiva ◽  
T Ribeiro ◽  
A.R. Coelho ◽  
R Silva ◽  
A.C. Real ◽  
...  

The authors read with attention the case report by Vande Berg and coworkers, published on a previous issue of this journal, describing a rare diagnosis of rectal metastases of an incognito invasive lobular breast carcinoma (ILC), for which immunohistochemistry was decisive (1). Likewise, we share a similarly rare case of gastrointestinal metastases of breast carcinoma (BC), in which immunohistochemistry played a pivotal role.A 55-year-old woman was diagnosed in June 2015 with an Invasive Breast Carcinoma of no-special-type (IBCNST) grade III, human epidermal growth factor receptor 2 (HER2) positive, estrogen and progesterone receptors (ER/PR) negative. Biopsy revealed vascular permeation. Neoadjuvant chemotherapy and trastuzumab preceded surgery, performed in December 2015, followed by radiotherapy and trastuzumab. The patient remained free of disease until 2017, when a right cerebellar lesion was diagnosed as BC metastasis and was treated with stereotactic radiosurgery. In January 2020, the patient presented with a 1-month history of post-prandial vomiting, epigastric pain, anorexia, fatigue, and a 10 kg weight loss. Lab tests were unremarkable, except for small increase in CA-125 and CA-15.3.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e22070-e22070
Author(s):  
Yayi He

e22070 Background: Epidermal growth factor receptor (EGFR) activating mutation is an important predictive biomarker of EGFR tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC), while family history of cancer also plays an important role in the carcinogenesis of lung cancer. This study aimed to investigate the association between family history of cancer and EGFR mutation status in NSCLC population. Methods: From February 2008 to May 2012, 538 consecutive NSCLC patients with known EGFR mutation status were included into this study. Amplification refractory mutation system (ARMS) method was used to detect EGFR mutation. The associations between EGFR mutation and family history of cancer were evaluated using logistic regression models. Results: EGFR activating mutation was found in 220 patients and 117 patients had family cancer histories among first-degree relatives. EGFR mutation was more frequently detected in adenocarcinoma patients (p<0.001), never-smoker (p<0.001) and with family history of cancer (p=0.031), especially who had family history of lung cancer (p=0.008). In multivariate analysis, the association of EGFR mutation with family history of cancer also existed (p=0.039). Conclusions: NSCLC Patients with family history of cancer, especially family history of lung cancer, might have a significantly higher incidence of EGFR activating mutation.


2021 ◽  
pp. 107815522110157
Author(s):  
Jeffrey Lombardi ◽  
Pauline Lory ◽  
Nils Martin ◽  
Didier Mayeur ◽  
Sandrine Combret ◽  
...  

Introduction Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate which combine trastuzumab (T), a monoclonal antibody targeting the human epidermal growth factor receptor-2 (HER2), and a cytotoxic molecule derived from maytansine (DM1). Case report We report the first case of T-DM1-associated pleural and pericardial effusions three weeks after the second course of T-DM1 in a patient with breast cancer. Drug-induced pleural and pericardial effusions was implicated in the absence of other etiologies. The Naranjo Scale indicated a probable drug-induced adverse reaction. Management & outcome: The patient fully recovered after thoracentesis and discontinuation of T-DM1. The patient has reported no side effect after the sixth course of trastuzumab. Discussion To our knowledge, this is the first case in the literature of bilateral pleural and pericardial effusions in a patient treated with T-DM1. The successful initiation of treatment with trastuzumab following withdrawal of T-DM1 suggests that emtansine played a role in the development of bilateral pleural and pericardial effusions. We hypothesize that the patient’s condition was a result of a local inflammatory reaction to emtansine by direct toxicity.


F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 933
Author(s):  
Alvise Sernicola ◽  
Salvatore Lampitelli ◽  
Sara Grassi ◽  
Antonio Giovanni Richetta ◽  
Stefano Calvieri

We present the case of a 60-year-old man with unresectable cutaneous squamous cell carcinoma (cSCC) of the sternal area, which was not amenable to radiation therapy. The treatment history of this patient is remarkable as the disease had progressed through all lines of conventional therapy established in the literature. We decided to initiate treatment with epidermal growth factor receptor (EGFR) inhibitor cetuximab and we reassessed the patient after 12 weeks with a whole-body CT scan, documenting stability in the size and radiologic features of the disease. Cetuximab, like all current treatments for advanced cSCC, is administered off-label and proved effective in preventing further progression of disease in our patient.


2020 ◽  
pp. 1-5
Author(s):  
Tony Kurian ◽  
Tony Kurian ◽  
Jason Peng ◽  
Courtney Regan Wagner ◽  
Fritzie S. Albarillo

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have demonstrated improved progression-free survival benefits and decreased treatment-related side effects, and therefore are now considered first-line of treatment of EGFR mutated, metastatic non-small cell lung carcinoma (NSCLC). Cryptococcal endocarditis is an extremely rare clinical entity with only seven reported cases in the literature. Prior cases were seen in patients with a history of rheumatic heart disease or prior valve replacement surgery. Little is known regarding the natural history and optimal management of Cryptococcal endocarditis, given the limited available data. We present a case of Cryptococcal endocarditis and meningitis in a patient with metastatic NSCLC receiving targeted therapy with an EGFR-TKI with no history of significant cardiac disease.


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