Laryngeal Cancer With Lung Metastases Showing Long-Term Complete Response and Delayed Immune-Related Adverse Event After Nivolumab Discontinuation

We report a case of laryngeal cancer with multiple lung metastases that maintained a complete response (CR) for 18 months after discontinuing nivolumab treatment, with colitis developing 5 months after drug discontinuation. A 65-year-old man was diagnosed with T3N2cM0 stage IVA right supraglottic squamous cell carcinoma that progressed after 1 course of TPF (cisplatin, docetaxel, and 5-fluorouracil) as induction chemotherapy. He underwent total laryngectomy, bilateral neck dissection, pharyngeal reconstruction with anterolateral thigh flap, and creation of a permanent tracheostoma; extranodal extension was detected in the right cervical lymph node metastasis, and the patient underwent adjuvant radiotherapy. Multiple lung metastases occurred during radiotherapy, and the patient was deemed platinum refractory; nivolumab treatment was thus initiated. The tumor proportion score for programmed death-ligand 1—evaluated via antibody testing of the laryngeal tumor—was <1. The patient received 240 mg/body nivolumab every 2 weeks; a computed tomography performed after course 16 of nivolumab treatment confirmed a CR. He exhibited grade 2 thyroid dysfunction, grade 1 interstitial pneumonia, and grade 2 colitis after 6, 7, and 14 months of receiving nivolumab, respectively; treatment was discontinued as despite maintaining a CR, interstitial pneumonia occurred twice. Colitis appeared 5 months after nivolumab discontinuation; nevertheless, a CR was maintained after 18 months.

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Stereotactic Body Radiotherapy of a Solitary Metachronous Sphenoid Metastasis from Renal Cell Cancer: A Case Report

Case Reports in Oncology ◽

10.1159/000513743 ◽

2021 ◽

pp. 269-273

Author(s):

Charles Marchand Crety ◽

Estelle Vigneau ◽

Camille Invernizzi

Keyword(s):

Renal Cell Cancer ◽

Renal Cell ◽

Stereotactic Body Radiation Therapy ◽

Clinical Presentation ◽

Histopathological Examination ◽

Cell Cancer ◽

Papillary Renal Cell Carcinoma ◽

Complete Response ◽

Resonance Imaging ◽

The Right

Nasosinus metastases from kidney cancer are an unusual clinical presentation although some cases are reported in the literature. Among these cases, sphenoidal metastases are even rarer. Here we report a case of lone sphenoid metastasis in patients with papillary renal cell cancer. Eight months after radical nephrectomy, the patient presented with progressively worsening diplopia. Magnetic resonance imaging showed a mass in the right sphenoid sinus. Histopathological examination of the biopsy sample confirmed diagnosis of sinonasal metastasis from papillary renal cell carcinoma. The patient was declined for surgical management and received stereotactic body radiation therapy. Reassessment MRI at 4 months showed a complete response of the treated sphenoid lesion.

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Pembrolizumab-Induced Severe Neuropathy in a Patient with Metastatic Urothelial Carcinoma after Achieving Complete Response: Guillain-Barré Syndrome-Like Onset

Case Reports in Oncology ◽

10.1159/000511567 ◽

2020 ◽

Vol 13 (3) ◽

pp. 1490-1494

Author(s):

Shuntaro Aoki ◽

Masato Yasui ◽

Hironao Tajirika ◽

Hideyuki Terao ◽

Makoto Funahashi ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Urothelial Carcinoma ◽

Lung Metastases ◽

Complete Response ◽

Guillain Barre Syndrome ◽

Node Metastasis ◽

Aortic Lymph Node ◽

Guillain Barré Syndrome ◽

Guillain Barré

An 85-year-old female was admitted to our hospital for left ureteral cancer and para-aortic lymph node metastasis. To control hematuria, a laparoscopic retroperitoneal nephroureterectomy was performed, and papillary urothelial carcinoma (pT3b) was found. To treat para-aortic lymph node metastasis, she received chemotherapy with gemcitabine and nedaplatin. After 2 cycles, a computed tomography scan revealed its disappearance; however, bilateral lung metastases appeared. The patient was administered second-line therapy with pembrolizumab every 3 weeks. After 3 courses, lung metastases disappeared and she achieved a complete response. After the fifth administration of pembrolizumab, she was readmitted with right upper limb pain and weakness in both lower extremities. She was diagnosed with pembrolizumab-induced grade 3 peripheral neuropathy with Guillain-Barré syndrome-like onset. High-dose monocorticotherapy was initiated for treatment. Three weeks later, the pain and weakness of the limbs improved. After discharge, the dose of prednisolone was tapered and there was no relapse of adverse events. Pembrolizumab was discontinued at the onset of neuropathy, but she maintained a complete response.

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RARE-29. PRIMARY CENTRAL NERVOUS SYSTEM NON-HODGKIN LYMPHOMA IN AN 11-YEAR-OLD BOY: A CASE REPORT

Neuro-Oncology ◽

10.1093/neuonc/noaa222.739 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii448-iii448

Author(s):

Jorge Luis Ramírez-Melo ◽

Regina M Navarro-Martin del Campo ◽

Manuel D Martinez-Albarran ◽

Fernando Sánchez-Zubieta ◽

Ana L Orozco-Alvarado ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Hodgkin Lymphoma ◽

Central Nervous System Lymphoma ◽

Complete Response ◽

High Dose ◽

Illustrative Case ◽

Tumor Biopsy ◽

Non Hodgkin Lymphoma ◽

The Right

Abstract BACKGROUND Primary central nervous system lymphoma (PCNSL) are very rare in children. CLINICAL CASE: An 11-year-old male presented with a 2 months history with myoclonic movements in the upper right limb, and a sudden frontal headache, gait disturbance due to right hemiparesis and an ipsilateral convulsive episode. Upon admission he had critical condition, with hypertensive skull syndrome, Glasgow of 12, Karnofsky 40%, right hemiparesis, swallowing disorder, facial paralysis, and loss of photo motor reflex and unilateral amaurosis. A CT and MRI showed a huge tumor mass in the left tempo-parietal region, infiltrating the white matter and shifting the midline. A Tumor biopsy was done, and reported diffuse small cell non-Hodgkin lymphoma of high-grade, Burkitt type. Systemic lymphoma workup was negative. He received six cycles of chemotherapy based on high dose methotrexate, rituximab and triple intrathecal.After the second cycle an ophthalmologic evaluation was done, and found infiltration to the right retina, for which 6 cycles of intra vitreous chemotherapy with methotrexate were applied, he showed an excellent response, and recovered all his neurological functions except that right hemianopia persist. Control MRI showed partial response at 2nd cycle and complete response after the 4th cycle. No Radiation was performed. CONCLUSION This report highlights the fact that pediatric PCNSL may be effectively treated by a combination of HDMTX and rituximab-based chemoimmunotherapy without irradiation. Lack of awareness of this rare entity may lead to extense resections of brain, and potential permanent secuelae that were avoided in this illustrative case.

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Risk factors for distant metastasis in locoregionally controlled oral squamous cell carcinoma: a retrospective study

Scientific Reports ◽

10.1038/s41598-021-84704-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hirofumi Tomioka ◽

Yuko Yamagata ◽

Yu Oikawa ◽

Toshimitsu Ohsako ◽

Takuma Kugimoto ◽

...

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Distant Metastasis ◽

Significant Risk ◽

Distant Metastases ◽

Cervical Lymph Node Metastasis ◽

Extranodal Extension

AbstractThe control of distant metastasis in oral squamous cell carcinoma is an important determinant of improved prognosis. The study aimed to identify risk factors for distant metastasis in patients with locoregionally controlled oral carcinoma. We identified 982 patients with oral squamous cell carcinoma treated at our hospital between January 2008 and December 2017. After excluding patients with distant metastasis at initial treatment, patients with metastasis to the oral cavity, those receiving palliative treatment, and those lacking follow-up data, 941 patients were selected. Finally, among these 941 patients, 887 with locoregionally controlled oral squamous cell carcinoma were included in the study. Among the 887 patients, 36 had confirmed distant metastasis (4.1%), and the lung was the most common site (31/36 patients, 86.1%). Multivariate analysis showed that the incidence of primary intraosseous carcinoma of the mandible, cervical lymph node metastasis at levels IV and V, and the presence of pathological extranodal extension were significant risk factors for distant metastasis. When treating patients with oral squamous cell carcinoma who are positive for the aforementioned risk factors, the possibility of developing distant metastases must be accounted for, and aggressive treatment should be planned accordingly.

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Diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery for treatment of hepatocellular carcinoma: a comparison of outcomes after N-butyl cyanoacrylate versus gelatin sponge embolization

Acta Radiologica ◽

10.1177/0284185120981771 ◽

2020 ◽

pp. 028418512098177

Author(s):

Seung Yeon Noh ◽

Dong Il Gwon ◽

Suyoung Park ◽

Woo Jin Yang ◽

Hee Ho Chu ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Complete Response ◽

Gelatin Sponge ◽

Inferior Phrenic Artery ◽

Gelatin Sponge Particles ◽

Phrenic Artery ◽

The Right ◽

Diaphragmatic Weakness ◽

Arterial Chemoembolization

Background The inferior phrenic artery (IPA) is the most common extrahepatic feeder for hepatocellular carcinoma (HCC) during transhepatic arterial chemoembolization (TACE). Purpose To compare the incidence of diaphragmatic weakness in patients with HCC after TACE of the right IPA conducted using either N-butyl cyanoacrylate (NBCA) or gelatin sponge particles. Material and Methods Medical records of 111 patients who underwent TACE of the right IPA using NBCA were retrospectively reviewed and compared with data from 135 patients with IPA embolization using gelatin sponge particles. Results The incidence of diaphragmatic weakness after the initial TACE procedure did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 20.7%; P = 0.458). Five patients in the NBCA group and 11 in the gelatin sponge group showed spontaneous resolution of diaphragmatic weakness after a mean period of 3.5 months. Diaphragmatic weakness developed after the initial follow-up visit in 17 patients from the gelatin sponge group due to repeated TACE of the right IPA (mean 2.4 sessions; range 2–4 sessions), while it spontaneously developed without additional TACE procedures in one patient from the NBCA group. Permanent diaphragmatic weakness was less common in the NBCA than in the gelatin sponge group (12.6% and 25.2%, respectively; P = 0.017). The complete response rate did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 25.9%; P = 0.065). Conclusion Use of NBCA rather than gelatin sponge particles for TACE of the right IPA resulted in a lower incidence of permanent diaphragmatic weakness.

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Canine Synovial Sarcoma of the Stifle Joint with Pulmonary and Liver Metastases

Tanzania Veterinary Journal ◽

10.4314/tvj.v38i1.2s ◽

2021 ◽

Vol 38 ◽

pp. 6-12

Author(s):

R.J. Samson ◽

F.H. Mpagike ◽

A.K. Felix ◽

A.B. Matondo ◽

M. Makungu

Keyword(s):

Soft Tissue ◽

Lung Metastases ◽

Synovial Cell ◽

Proximal Region ◽

Radiographic Examination ◽

Tissue Samples ◽

Stifle Joint ◽

Mongrel Dog ◽

Biopsy Examination ◽

The Right

A seven-year-old female mongrel dog was presented at the Sokoine University of Agriculture Teaching Animal Hospital for second opinion regarding a progressive swelling of the right hind limb of two months duration. Clinical examination revealed a loss of body condition, tachypnea and tachycardia, a painful immobile solid mass of 20 cm x 14 cm x 10 cm located on the right stifle joint, leucocytosis, and anaemia. Radiographic examination of the joint revealed marked soft tissue swelling with amorphous areas of mineralization and complete destruction of the proximal tibia. Smooth and solid periosteal reaction was seen around the tibia and fibula with a Codman’s triangle. Multiple nodules and a mass with soft tissue opacity were seen in the lung fields. Post-mortem examination revealed separation of tibia and fibula, softening of the proximal parts of the tibia, and complete integration of the proximal region of the two bones and articular tissues into the surrounding muscular tissues. Multifocal nodular lesions of variable sizes were mostly found in the lungs and partly in the liver. Histologically, predominantly oval and round cells with variable nuclear sizes and moderate mitoses were observed in tissue samples from the joint, lungs and the liver although some parts of the lung metastases showed both round and spindle shaped tumor cells. Clinical profile is suggestive of aggressive biphasic (spindle and epithelial) type of synovial cell sarcoma with lung and liver metastasis. Early radiographic and biopsy examination of persistent musculoskeletal nodules is recommended for early diagnosis and interventions.

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Change from triple negative type to triple positive type: A case report of discordance of re-biopsy from primary breast cancer

10.36879/jcmi.20.000126 ◽

2020 ◽

pp. 1-5

Keyword(s):

Primary Tumor ◽

Triple Negative ◽

Lobular Carcinoma ◽

Rare Event ◽

Metastatic Tumor ◽

Complete Response ◽

Current Treatment ◽

Positive Type ◽

Impact On Treatment ◽

The Right

The patient was a 60-year-old woman who had visited a clinic with the chief complaint of a mass in the right breast prior to being referred to our hospital. Breast examination revealed the presence of a 3-cm hard elastic mass in the C region of the right breast. Computed tomography (CT) further indicated metastases to the liver and lungs. Upon needle biopsy of the primary tumor, the patient was diagnosed with triple-negative (ER (-), PgR (-), HER2 (-)) invasive lobular carcinoma. Chemotherapy was successful in achieving a transient partial response (PR); however, the tumor later advanced to a progressive disease (PD) after five cycles of oral fluoropyrimidine derivative therapy (S-1). Re-biopsy of the primary tumor revealed that the tumor was triple-positive (ER (+), PgR (+), HER2 (+)). The patient was subsequently treated with anti-HER2 therapy and has since achieved complete response (CR). Although biological changes sometimes occur from the primary to the metastatic tumor, changes in the primary tumor itself during the course of treatment is a rare event. Furthermore, the transition from triple-negative to triple-positive status is very uncommon. Re-biopsy rarely changes the biological characteristics of a tumor; however, biological changes can have a significant impact on treatment if they do occur. Thus, it is important to perform a re-biopsy if the current treatment results in PD.

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Complete Response to Chemotherapy in Intra-Abdominal Desmoplastic Small round Cell Carcinoma. A Case Report

Tumori Journal ◽

10.1177/030089169808400320 ◽

1998 ◽

Vol 84 (3) ◽

pp. 412-416 ◽

Cited By ~ 3

Author(s):

Mario De Lena ◽

Maria Lucia Caruso ◽

Franco Marzullo ◽

Sergio Mancarella ◽

Raffaele Armentano ◽

...

Keyword(s):

Good Health ◽

Complete Response ◽

Complete Disappearance ◽

Round Cell ◽

Small Round Cell ◽

Response To Chemotherapy ◽

Lower Abdominal Quadrant ◽

Antineoplastic Treatment ◽

Multiagent Chemotherapy ◽

The Right

Aims and background The authors report the case of a 23-year-old woman affected by intra-abdominal desmoplastic small round cell tumor (DSRCT) who obtained a complete response to multiagent chemotherapy. DSRCT is a rare, highly aggressive neoplasm generally arising in young people and seldom in females (about 20 cases described in the literature). Methods The patient underwent surgical resection of a large 15 × 15 cm mass located in the right lower abdominal quadrant, but after only 2 months later, two liver metastasis were noted. Thus, she was subjected to an aggressive antineoplastic treatment consisting of three groups of alternating non-cross resistant multiagent regimens administered every 21 days (cis-platin-etoposide-adriamycin-bleomicin; gemcitabine-ifosfamide-dacarbazine; methotrexate-5-fluorouracilfolinic acid) for a total of 9 administrations. Results After one cycle of treatment including the administration of all the three alternated schemes of chemotherapy, a complete disappearance of liver disease was noted. The treatment was relatively well-tolerated and the toxicity was acceptable. At present, after 15 months from diagnosis and 12 months after starting chemotherapy, the patient is disease-free and in good health. Conclusions Even though this study regards only a single patient, it is noteworthy because of the rarity of this neoplasm and because of the infrequent complete responses reported in the literature. The efficacy and manageability of the treatment, suggests that both the timing and schedule used could constitute an important therapeutical option for this aggressive and poorly chemo-responsive tumor.

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Case Report: Bilateral Pneumothoraces Due To Targeted Tumor Therapy With Regorafenib in a Young Woman With Metastatic Colorectal Cancer

10.21203/rs.3.rs-991839/v1 ◽

2021 ◽

Author(s):

Tobias Rachow ◽

Tim Sandhaus ◽

Thomas Ernst ◽

Helmut Schiffl ◽

Susanne M. Lang

Keyword(s):

Colorectal Cancer ◽

Chest Pain ◽

Pulmonary Metastases ◽

Lung Metastases ◽

Tumor Therapy ◽

Tension Pneumothorax ◽

Cancer Case ◽

Pretreated Patient ◽

Breath Sounds ◽

The Right

Abstract Background: Colorectal cancer is one of the most common cancer types, frequently metastasizing into the lungs. Treatment options have been vastly improved over the last years. With the increasing use of targeted therapies novel and rare adverse effects can be seen. In this report, we present the case of recurrent spontaneous bilateral pneumothorax due to fulminant tumor necrosis during the administration of regorafenib in a heavily pretreated patient with multiple lung metastases from colorectal cancer. Case presentation: A 43-year-old woman presented in our oncology department with chest pain and dyspnea. The patient was diagnosed with colorectal cancer seven years earlier and had received chemoradiation, surgery and multiple chemotherapies, before she was started on regorafenib because of progressive pulmonary metastases. Clinical examination revealed no breath sounds in the right hemithorax. The patient was tachycardic and orthopneic. Computed tomography scans demonstrated cavitation of former nodular bilateral pulmonary metastases. After drainage and resolution of the right-sided pneumothorax the patient returned eleven days later with recurrent dyspnea, chest pain and subcutaneous emphysema. Bilateral pneumothoraces were treated with chest tubes. Due to left-sided tension pneumothorax video-assisted thoracoscopy and bilateral pleurodeses were performed. Persistent air leaks with severe pain and pulmonary infiltrates led to the death of the patient. Conclusions: Our case illustrates the effectiveness of regorafenib in a highly pretreated patient. However, in our patient the ensuing cavitation of the multiple nodes led to recurrent pneumothoraces and associated infectious complications. Therefore, special surveillance should be implemented to detect potential transformation of solid pulmonary metastases during treatment with this multi-kinase inhibitor.

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Transarterial Radioembolization Treatment of Advanced Hepatocellular Carcinoma Invading the Right Atrium

10.47363/jonrr/2021(2)139 ◽

2021 ◽

pp. 1-4

Author(s):

Kabalane Yammine ◽

◽

Sarah Khalife ◽

Keyword(s):

Hepatocellular Carcinoma ◽

Inferior Vena Cava ◽

Right Atrium ◽

Tumor Thrombus ◽

Inferior Vena ◽

Vena Cava ◽

Treatment Strategies ◽

Complete Response ◽

Advanced Hepatocellular Carcinoma ◽

The Right

Tumor thrombus infiltration of hepatocellular carcinoma (HCC) into the inferior vena cava and right atrium is rare and is associated with a poor prognosis due to the critical location of the tumor and the limited efficiency of the available treatment strategies. In this study, we report the case of a patient with advanced HCC and tumor thrombus in the inferior vena cava and right atrium who demonstrated complete response with mass retraction upon Yttrium-90 trans-arterial radioembolization (90Y- TARE) therapy. Throughout the 16 months follow-ups after the radioembolization, the patient was free of any complications, revealing no occurrence of radiation-induced pneumonitis or tumor recurrence.

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