Sarcoidosis-like disease with pulmonary infestation, meningoencephalitis and transverse myelitis after sigmoid cancer treatment

We present the case of a 40-year-old male with recent history of moderately differentiated invasive adenocarcinoma of the sigmoid in whom both respiratory and neurological disease developed simultaneously, mimicking diffuse metastatic disease. The broad differential diagnosis and pitfalls (both diagnostic and therapeutic) are described. Pulmonary sarcoidosis as well as neurosarcoidosis occur very rarely after solid cancers.

LAPOROSCOPIC PELVIC EXENTERATION FOR TREATMENT OF PRIMARY MULTIPLE CANCER. CASE REPORT

This clinical case represents the experience of surgical treatment of a patient with multiple primary metachronous cancer: 1. Sigmoid cancer рТ4NxM0. Resection of sigmoid colon (16.12.2013). Three courses of adjuvant chemotherapy (XELOX). Recurrence (2015). Laparotomy, Colproctectomy with D3 paraaortic lymph dissection. Ileostomy (2015). One course of chemotherapy (XELOX). 2. Upper tract urothelial carcinoma (right ureter) pT2N0M0R0. Right nephroureterectomy with the resection of the bladder and right testicular cord, cystostomy (19.02.2015). Recurrence. Nephrostomy drainage of the left kidney. Adhesive disease. Rectovesical fistula. Taking into account the history and comorbid status of the patient, it was decided to perform laparoscopic supralevator pelvic exenteration, ureterectomy on the left. The duration of the operation was 280 minutes, intraoperative blood loss was 200 ml. The period of stay in intensive care is 24 hours, the patient was discharged on the 7th day after the operation, the resection margin was negative (R0). After 12 months, there is no data for the disease progressed.

EP.FRI.1030 Splenic rupture in an obstructed colorectal cancer

Aims A case report of a splenic rupture resulting from an obstructed sigmoid cancer in a 62 year old patient. Patient presented with colorectal cancer symptoms, suddenly developed severe abdominal pain and hypotensive shock, a diagnosis of splenic rupture resulted in early surgical intervention (splenectomy, Hartman’s resection). Conclusion Atypical presentations could have adversely delayed the diagnosis of splenic rupture. Serial clinical assessments and observations, supported by serological and radiological tests is crucial in the management and can lead to early surgical intervention in an unstable patient. Prompt resuscitation and imaging facilitated an early diagnoses and surgical management. CT scan showed large volume of haemo-peritoneum with evidence of splenic rupture. Spleen histopathology was generally normal, with a potential of angiomatosis, but no metastatic disease. Emergency colorectal cancers still accounts for 20% of all colorectal cancers. Splenic rupture is a rare complication in an obstructed colorectal cancer, but under-reported. Traumatic splenic rupture accounts for approximately 75 % whilst atraumatic represents less than 12 %. Splenic rupture can occur in the presence of splenic neoplasms as either primary or secondary disease. This is caused by excessive traction on the spleno-colic ligament causing avulsion and tear of splenic capsule, heamatoma and subsequent spleen rupture. This can be considered as internal trauma to a viscus organ. Awareness of such a mechanism of splenic rupture in an obstructed sigmoid cancer can lead to an earlier diagnosis and get better outcomes, in the absence of trauma.

Chemotherapy During Active SARS-CoV2 Infection: A Case Report and Review of the Literature

COVID-19 has become the biggest public health problem and one of the most important causes of death in many countries in the world. SARS-CoV-2 infection is most likely to be fatal in elderly patients with concomitant diseases. In this article we present two cases of asymptomatic SARS-CoV-2-positive patients suffering from cancer who were treated with chemotherapy. The first case, a patient with primary mediastinal B-cell lymphoma, shows that confirmed SARS-CoV-2 infection does not have to be a contraindication to chemotherapy. We describe the course of disease and discuss doubts related to the choice of chemotherapy regimen. The second patient was a male with metastatic sigmoid cancer treated with FOLFOX4 as first-line palliative chemotherapy. This case draws attention to asymptomatic SARS-CoV-2 carriers who underwent chemotherapy. Our patient was safely treated with chemotherapy without long break caused by viral infection. It should be remembered that there are asymptomatic carriers among cancer patients and that they may spread infection to others. On the other hand, delaying chemotherapy can cause rapid disease progression and reduce overall survival of our patients.