BJMO - volume 19, issue 1, january 2025
L. Naert MD, S. Proost MD, A. Driessen MD, PhD, T. Vandamme MD, PhD
Jaundice in a patient with renal cell carcinoma is most frequently caused by liver metastasis and has a poor prognosis. However, multiple paraneoplastic phenomena are described in renal cell carcinoma, including a Stauffer syndrome variant with jaundice. In this case report we present the case of a woman in her 80s with jaundice in a newly diagnosed renal cell carcinoma. Hepatic metastasis was ruled out, and the differential diagnosis with the Stauffer syndrome, variant, vanishing bile duct syndrome, and hepatotoxicity was made. Due to the rapid fatal ending, it was not possible to evaluate the reversibility of the hepatic dysfunction after nephrectomy.
(BELG J MED ONCOL 2025;19(1): 36–39)
Read moreBJMO - volume 19, issue 1, january 2025
E. De Smet MA, D. Schrijvers MD, PhD, K. De Muynck MD, A. Vandebroek MD, E. De Droogh MD
This case report describes a sarcoid like reaction (SLR) in a patient with HER2-positive breast cancer undergoing treatment with trastuzumab and pertuzumab. SLRs are granulomatous reactions characterized by non-caseating epithelioid granulomas that can occur in cancer patients in response to infection, malignancy, or drugs. If found they have the potential to complicate radiological interpretations, mimic disease progression and challenge treatment evaluation. In HER2-positive breast cancer treated with trastuzumab, drug-induced SLRs have been reported, although not commonly. Clinicians should be aware of this entity, and when in doubt, tissue biopsy is needed to avoid misdiagnosis.
((BELG J MED ONCOL 2025;19(1):32–35)
Read moreBJMO - volume 19, issue 1, january 2025
E. Van Haute MD, D. Schrijvers MD, PhD, R. Steinkamm , K. Beel MD, PhD, An Vandebroek MD
We describe a patient with an ovarian cancer and an extensive prior treatment history presenting with abdominal pain and acute deterioration of anaemia and thrombocytopenia. Diagnosis of therapy-related myeloid neoplasm was made. Early recognition and diagnosis of therapy-related myeloid neoplasms pose an important challenge for the oncologist. They are essential in improving outcomes. A review of current insights regarding therapy-related myeloid neoplasms is provided.
(BELG J MED ONCOL 2025;19(1):27–31)
Read moreBJMO - volume 18, issue 7, november 2024
Y. Vanbiervliet MD, H. Vandekerckhove MD, N. Van Tittelboom MA, V. Neyrinck MD, V. Renard MD, S. De Waele MA
This case report discusses a 76-year-old woman with a history of epilepsy and cerebral aneurysms who underwent surgical intervention for stage III malignant melanoma and subsequently received pembrolizumab as adjuvant immunotherapy. Four weeks post-treatment initiation, she presented with unilateral ptosis and was diagnosed with a complex immune-related adverse event involving myocarditis, myositis, and myasthenia gravis, termed the triple M syndrome. The patient exhibited elevated cardiac and muscular biomarkers, deranged liver enzymes, hypothyroidism, severe aortic valve insufficiency, and decreased systolic function. Comprehensive diagnostic assessments ruled out structural abnormalities and ischaemic disease, prompting the initiation of high-dose IV corticosteroids. The patient’s clinical course involved steroid resistance, necessitating an escalation of corticosteroids and the introduction of mycophenolic acid as second-line immunosuppressive therapy. A positive evolution was observed with a resolution of ptosis and improvement of cardiac biomarkers, including troponin levels, leading to successful discharge.
(BELG J MED ONCOL 2024;18(7):279–281)
Read moreBJMO - volume 18, issue 6, october 2024
A. Bouzidi Ilias MD, F. Bosmans MD, A. Van Beeck MD, D. Schrijvers MD, PhD
Presacral myelolipomas are exceedingly rare benign tumours composed of mature adipose tissue and haematopoietic elements. Here, we present a case report of an 81-year-old male with a complex medical history, who presented with recurrent disabling back pain and haematuria. Initial evaluation showed a presacral lipomatous mass, raising concerns of a liposarcoma. Multidisciplinary discussion raised the possibility of a presacral myelolipoma and suggested a nuclear scan for confirmation of this diagnosis. Given the absence of symptoms due to the presacral mass and patient comorbidities, a watchful waiting approach was adopted. This case underscores the diagnostic challenges associated with presacral masses, emphasising the necessity for accurate identification to guide optimal management strategies. Heightened awareness among clinicians and radiologists is crucial for timely and accurate management decisions in such cases. This report contributes to the existing literature by highlighting the diagnostic process and management of this rare entity.
(BELG J MED ONCOL 2024;18(6):239-243)
Read moreBJMO - 2024, issue 3, may 2024
L. Decraene MD, H. Van Hoecke MD, PhD, C. Braet MD, E. Humble MD, C. Jacobs MD, M. Saerens MD, D. Stevens MD, I. Dhooge MD, PhD
Immune checkpoint inhibitors (ICI) are an increasingly used form of cancer immunotherapy (IT) with improved overall survival and efficacy compared to conventional chemotherapies in advanced cancers like non-small cell lung carcinoma (NSCLC) and melanoma. However, immune-related adverse events (irAEs) are still common and can be severe. In rare cases, inner ear irAEs have been reported. A pilot prospective longitudinal study was conducted in thirteen patients with melanoma or NSCLC treated with an ICI. A questionnaire based on the Speech, Spatial, and Qualities of Hearing Scale (SSQ), the Health Utilities Index Mark 2 and Mark 3 (HUI2/3), and the So Stoned questionnaire was used in conjunction with audiovestibular testing at baseline, three and six months. Seven out of thirteen patients showed irAEs. Despite inner ear irAE being rare, this study identified one patient with acute bilateral hearing loss within the study group of thirteen patients. Due to the increased use of immunotherapy, it is expected that the number of patients with acute inner ear pathology will rise. In this regard, awareness can lead to prompt diagnosis and treatment, as well as a better understanding of the pathophysiology and incidence of audiovestibular irAE.
(BELG J MED ONCOL 2024;18(3):89–94)
Read moreBJMO - volume 18, issue 2, march 2024
L. Verbeke MD, E. Roussel MD, PhD, C. Maes MD, K. Coppens MD
Renal tumours are often incidentally detected in routine imaging studies. Whereas renal cell carcinoma (RCC) represents the mainstay of malignant tumours arising from the kidney, other tumoural entities might also present as a single, localised renal mass. Primary renal lymphoma (PRL) is a distinct, rare and often aggressive presentation of lymphoma confined to the kidney, often mistaken for RCC or other renal tumours. It is defined as a non-Hodgkin lymphoma of the kidney without any extra renal lymphatic disease. Symptoms are often haematuria or flank pain. In 50% of the cases, patients are asymptomatic. The pathophysiology is not well understood. Imaging can be helpful in making the right diagnosis, but renal mass biopsy appears to be more sensitive. The treatment of choice is chemotherapy. The prognosis is rather poor, with a median survival of less than one year. Since the introduction of the new chemotherapy combination with rituximab, the prognosis is slightly better. PRL needs to be a differential diagnosis in renal tumours, especially with atypical tumour characteristics. This article presents a recent case of primary renal lymphoma.
(BELG J MED ONCOL 2024;18(2):60–64)
Read more
Top
