| 1. |
- Bjursten, Sara, et al.
(författare)
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Response to BRAF/MEK Inhibition in A598_T599insV BRAF Mutated Melanoma
- 2019
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Ingår i: Case Reports in Oncology. - : S. Karger AG. - 1662-6575. ; 12:3, s. 872-879
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Tidskriftsartikel (refereegranskat)abstract
- Approximately 50% of patients with metastatic melanoma harbor an activating BRAF mutation. Tumors with activating mutation BRAF gene proliferate excessively and can be treated with targeted BRAF-inhibitors in combination with MEK inhibitors. The most common BRAF mutation occurs at amino acid position 600. Other BRAF mutations are rare and their predictive value for treatment response to BRAF/MEK inhibition is low. Here, we report on a patient with a BRAF A598_T599insV mutated melanoma, a mutation that has only been described in one previous melanoma patient in which the treatment response to BRAF/MEK inhibition was transient. Our patient had a large ulcerated metastasis that showed a durable complete response implying that BRAF/MEK inhibition should be considered a treatment option for this mutation. We analyzed circulating cell-free tumor DNA (ctDNA) carrying the BRAF A598_T599insV mutation throughout treatment. The allele frequency of BRAF A598_T599insV decreased during regression of the tumors, indicating that this method has potential to monitor treatment response. Our case demonstrates durable response to BRAF/MEK inhibition in a melanoma patient carrying a BRAF A598_T599insV mutation. In addition, we show that allele frequency analysis of A598_T599insV mutation in blood using ultrasensitive sequencing can be used to monitor treatment response.
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| 2. |
- Bäcklund, M, et al.
(författare)
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Microwave Ablation and Immune Activation in the Treatment of Recurrent Colorectal Lung Metastases: A Case Report
- 2017
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Ingår i: Case reports in oncology. - : S. Karger AG. - 1662-6575. ; 10:1, s. 383-387
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- We present a patient with colorectal metastases confined to the lungs and treated with multiple resections until this was not an option anymore, followed by stereotactic body radiation therapy until this option was drained. Then, the patient was successfully treated with multiple microwave ablations combined with immunological activation targeting the programmed cell death 1 receptor (PD-1), possibly instigating a powerful abscopal effect. Techniques, doses, and radiological findings are presented.
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| 3. |
- Eigeliene, N, et al.
(författare)
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Metastatic Rectal Carcinoma with Long-Term Remission due to Modern Multimodality Treatment
- 2021
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Ingår i: Case reports in oncology. - : S. Karger AG. - 1662-6575. ; 14:3, s. 1475-1482
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In the era of personalized medicine, systemic treatment with chemotherapy in combination with targeted drugs, tailored according to <i>RAS</i> and <i>BRAF</i> status, has improved the survival of patients with metastatic colorectal cancer (mCRC), but curative resection of metastases provides the only chance of cure. Here, we present a 40-year-old male with rectal adenocarcinoma and multiple bilateral synchronous liver metastases who has achieved long-term remission with multimodal treatment without resection of all metastatic lesions. This case emphasizes the need of repeated multidisciplinary team assessments and change of treatment intent if extraordinary responses are seen. The initial therapy consisted of short-course radiotherapy and surgery of the primary tumor followed by oxaliplatin-based combination chemotherapy and panitumumab with disease control intent. A complete radiologic response in >20 liver metastases in segments II–VIII was obtained. A biopsy-verified relapse of 3 liver metastases occurred at 9 months of treatment pause. Subsequently, major liver resection of 8 lesions was performed (4 with adenocarcinoma and 4 with cicatrix showing the challenge of disappearing lesions), followed by 6 months of adjuvant-like therapy. No relapse in MRI, PET, or CT has been noted since liver resection 6 years ago. Comprehensive genomic profiling of the primary tumor and liver metastases had similar driver mutations representing a low level of gene alteration and low diversity, possibly explaining the exceptional treatment response.
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| 4. |
- Freedman, J, et al.
(författare)
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Navigated Percutaneous Lung Ablation under High-Frequency Jet Ventilation of a Metastasis from a Wilms' Tumour: A Paediatric Case Report
- 2016
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Ingår i: Case reports in oncology. - : S. Karger AG. - 1662-6575. ; 9:2, s. 400-404
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Tidskriftsartikel (refereegranskat)abstract
- This is a case report of microwave energy being used to ablate an inoperable metastasis of a Wilms’ tumour in a 6-year-old boy using state-of-the-art navigated computed tomography targeting and high-frequency jet ventilation to reduce organ displacement and the potential risk of procedure-related pneumothorax. After the ablation, the young boy had high-dose chemotherapy followed by an autologous stem cell transplantation with rapid reduction of three recurrent right-sided lung metastases.
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| 5. |
- Giglio, Daniel, 1977, et al.
(författare)
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Immune Checkpoint Inhibitor-Induced Polymyositis and Myasthenia Gravis with Fatal Outcome.
- 2020
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Ingår i: Case reports in oncology. - : S. Karger AG. - 1662-6575. ; 13:3, s. 1252-1257
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Tidskriftsartikel (refereegranskat)abstract
- We here report on a 74-year-old man diagnosed with a pT3cN0 BRAF-mutated and mismatch repair-deficient adenocarcinoma in the colon ascendens and 3 liver metastases. After hemicolectomy, the patient received treatment with the PD-1 inhibitor pembrolizumab. Three weeks later (on day 22), laboratory tests showed leukocytosis and an increase in transaminases; immune checkpoint inhibitor (ICI)-induced hepatitis was suspected and prednisolone therapy was initiated. On day 29, the patient was acutely hospitalized due to dyspnea, somnolence and walking difficulties. Dysarthria, hoarseness, muscle pain and weakness had developed and the dose of prednisolone was increased. Serum levels of lactate dehydrogenase, creatine kinase and myoglobin were increased and ICI-induced myositis was suspected. Antibodies against acetylcholine receptor and titin were present, indicating myasthenia gravis. Eventually, bulbar myopathy developed, including dysarthria and dysphagia, and the patient could no longer attain saturation without oxygen. The patient was transferred to the intensive care unit, intubated and given methylprednisolone, intravenous immunoglobulins and infliximab. The patient developed carbon dioxide retention and died on day 39. Microscopical examination of the intercostal musculature, diaphragm, cervical musculature and tongue showed inflammatory infiltration and fibrosis consistent with a pronounced myositis. In the liver, microscopical examination did not show metastases from colorectal cancer but instead a hepatocellular cancer. The cause of death was determined as respiratory insufficiency due to polymyositis. In conclusion, ICIs may induce myositis combined with neurological immune-related adverse events. In patients developing muscle weakness and pain under ICI therapy, myositis should be suspected.
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| 6. |
- Hadimeri, U., et al.
(författare)
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Membranoproliferative Glomerulonephritis and Inflammatory Pseudotumour of the Spleen
- 2013
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Ingår i: Case Reports in Oncology. - : S. Karger. - 1662-6575. ; 6:1, s. 84-89
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Tidskriftsartikel (refereegranskat)abstract
- Inflammatory pseudotumour is a rare condition that can affect various organs. The clinical and histologic appearance of the pseudotumour may mimic haematological, lymphoproliferative, paraneoplastic or malignant processes. A previously healthy 39-year-old man presented with nephrotic syndrome. He had a history of headaches, nausea and swollen ankles. Computed tomography of the abdomen revealed a 6-cm mass in the spleen. Following a renal biopsy, a diagnosis of membranoproliferative glomerulonephritis (MPGN) type I was made. Splenectomy was performed and the examination revealed a mixed population of lymphocytes with predominantly T-cells, B-cells and lymphoplasmacytoid cells. Immunostaining confirmed that the small cells were mostly T-cells positive for all T-cell markers including CD2, CD3, CD4, CD5, CD7 and CD8. A diagnosis of inflammatory pseudotumour was established. The removal of the spleen was followed by remission of glomerulonephritis, but it was complicated by a subphrenic abscess and pneumonia. This association between an inflammatory pseudotumour of the spleen and MPGN has not been previously described. Abnormal immune response due to the inflammation leading to secondary glomerulonephritis might be the main pathogenic mechanism.
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| 7. |
- Hultborn, Ragnar, 1946, et al.
(författare)
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Male Breast Carcinoma after Irradiation and Long-Term Phenothiazine Exposure : A Case Report
- 2020
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Ingår i: Case Reports in Oncology. - : S. Karger AG. - 1662-6575. ; 13:2, s. 956-961
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Tidskriftsartikel (refereegranskat)abstract
- We present a young male patient with breast cancer having several risk factors likely acting in consort: irradiation of the breast for gynecomastia in adolescence and a life-long administration of phenothiazine for schizophrenia from the age of 16 years, with elevated serum prolactin level resulting in breast cancer development 24 years after irradiation.
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| 8. |
- Johansson, EK, et al.
(författare)
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Severe Photo Toxicity Recalled by Docetaxel
- 2018
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Ingår i: Case reports in oncology. - : S. Karger AG. - 1662-6575. ; 11:3, s. 751-755
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Photo-recall phenomenon is a rarely recognized adverse event of chemotherapeutic agents. The physiopathology of this entity is unclear. We have reported a 56-year old breast cancer patient with severe photo toxicity recalled 5 months after the initial sunburn by one course of adjuvant docetaxel treatment. However, being given right diagnosis and proper managements the patient could be able to complete her adjuvant chemotherapy according to the planed time schedule, without any delay. Our case may be explained by the theory that long-lived memory T-cells may remember former skin damage and cross-react with cytotoxic drugs. In addition, we have proved that weekly paclitaxel can still be the drug of option after docetaxel recalled severe photo toxicity.
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| 9. |
- Larsson, Anders, et al.
(författare)
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Falsely elevated thyroid-stimulating hormone results dueto Interference by M-component of IgG-lambda type
- 2020
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Ingår i: Case Reports in Oncology. - : S. Karger. - 1662-6575. ; 13:2, s. 680-682
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Tidskriftsartikel (refereegranskat)abstract
- Heterophilic antibodies but also M-components can interfere with laboratory tests causing erroneous results. We report the case of a 75-year-old man with myeloma and a monoclonal immunoglobulin component (M-component) that caused elevated thyroid-stimulating hormone (TSH) results. The M-component was of the IgG-lambda type. Thyroid markers were analyzed repeatedly, and there was a clear association between IgG concentrations and TSH values (R 2 = 0.724). The highest TSH value was 75 mIU/L. Polyethylene glycol (PEG) precipitation of intact immunoglobulins was used to investigate if there was an antibody-related interference problem. The PEG treatment normalized the TSH value, showing that the cause of the elevated TSH result was due to interference caused by the M-component. In conclusion, it is important to remember that both heterophilic antibodies and M-components may cause erroneous results.
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| 10. |
- Nilsson, Åse, et al.
(författare)
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Primary Pericardial Mesothelioma: Report of a Patient and Literature Review
- 2009
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Ingår i: Case Reports in Oncology. - Basel : S Karger AG. - 1662-6575. ; 2:2, s. 125-132
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Tidskriftsartikel (refereegranskat)abstract
- Primary mesothelioma of the pericardium is a rare tumor and carries a dismal prognosis. This case report presents a 38-year-old man who suffered from recurrent pericardial fluid. Initial symptoms were unspecific, with dry cough and progressing fatigue. Pericardiocentesis was performed, but analyses for malignant cells and tuberculosis were negative. After recurrence a pericardiectomy was planned. At operation, partial resection of tumor tissue surrounding the heart was performed. Histopathologic examination including immunohistochemical staining for calretinin showed a biphasic mesothelioma. During the postoperative period the patient’s condition ameliorated, but symptoms recurred and the patient died 3 months after diagnosis and 15 months after the first symptoms. At autopsy, the pericardium was transformed by the tumor that also expanded into the mediastinum and had set metastases to the liver. A review of 29 cases presented in the recent literature indicates a higher incidence of malignant pericardial mesothelioma among men than women. Median age was 46 (range, 19–76) years. In pleural mesotheliomas, exposure to asbestos is a known risk factor. However, in primary pericardial mesotheliomas the evidence for asbestos as an etiologic factor seems to be less convincing (3 exposed among 14 cases). Symptoms are often unspecific and cytologic examination of pericardial fluid is seldom conclusive (malignant cells demonstrated in 4/17 cases). Partial resection of the tumor can give a period of symptom reduction. Only a few patients have been treated with chemotherapy. Median survival of patients with pericardial mesotheliomas is approximately 6 months.
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