BJMO - volume 16, issue 3, may 2022
M. Saerens MD, I. Hilderson MD, L. Brochez MD, PhD, A. Hoorens MD, PhD, C. Jacobs MD
Pyrexia is a frequent complication of the treatment with BRAF and MEK inhibitors. Its management includes a full infectious workup, initiation of paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), dose interruption and steroids. In rare cases, pyrexia is refractory to steroids. Pathogenesis of pyrexia shows similarities with familial Mediterranean fever, a disease that usually responds well to colchicine. This study presents a case of refractory pyrexia due to BRAF and MEK inhibitors in metastatic melanoma, successfully treated with colchicine, which paved the path for a significant treatment response.
(BELG J MED ONCOL 2022;16(3):128–32)
Read moreBJMO - volume 16, issue 3, may 2022
L. Baisier MD, A. Buttiens MD, A. Eyben MD, M. Viaene MD, H. De Cauwer MD
Adenocarcinoma of the ampulla of Vater is a biliary tumour arising from the distal biliary epithelium at the ampulla of Vater. It is a relatively rare tumour, accounting for approximately 7% of all periampullary malignancies. Leptomeningeal metastasis, a complication occurring in 5% of all cancer patients, is a feature very seldomly reported in this type of malignancy. The prognosis is very poor, as current treatment options for leptomeningeal metastasis are limited by low efficacy and high toxicity. This study presents the case of a patient with an ampullary adenocarcinoma, who first was treated with surgical resection for localised disease. However, the disease evolved and palliative chemotherapy was started when colonic metastases became evident. Twelve months after diagnosis, leptomeningeal metastases were detected. To our knowledge, only one similar case has been reported previously, slightly different from the type of ampullary carcinoma presented in this study. Leptomeningeal metastasis should always be considered in a patient presenting with neurologic signs and a history of an ampullary malignancy.
(BELG J MED ONCOL 2022;16(3):125–7)
Read moreBJMO - volume 16, issue 2, march 2022
D. Naudts MD, L-A. Teuwen MD, PhD, J. Van Boven , H. Prenen MD, PhD, T. Vandamme MD, PhD, B. Van Overberghe MD, K. Forceville MD, M. Peeters MD, PhD
5-Fluorouracil (5-FU) and its prodrug capecitabine are widely used and generally well-tolerated chemotherapeutic agents. Although leucovorin, a derivative of folic acid, is routinely used to potentiate the effect of 5-FU, there seems to be little to no awareness about a similar interplay between capecitabine and folic acid, a commonly used supplement. This study presents a case in which a high concentration of folic acid led to fatal capecitabine-related toxicity, with the aim to raise awareness on the interaction between folic acid supplementation and 5-FU/capecitabine treatment toxicity.
(BELG J MED ONCOL 2022;16(2):74–8)
Read moreBJMO - volume 16, issue 1, february 2022
A. Feyaerts MD, W. Demey MD, P. Hullegie
Complications in totally implantable venous access devices can occur in an early or late stage and can be severe. This case reports an uncommon complication with atypical presentation. A 61-year-old female, treated with mFOLFIRI due to stage IV colorectal cancer, experienced significant thoracic pain, diaphoresis and dyspnoea after administration of the 5FU bolus. This was followed by erythema of the skin surrounding the totally implantable venous access device, presented by the patient at the outpatient clinic two weeks later. No evidence of cardiovascular, pulmonary or septic complications was found. Radiographic imaging with contrast showed a misplaced venous access device guided into the right internal thoracic vein. After readjustment of the catheter, no further complications had occurred. Even though mispositioning of a venous access device is rarely documented as a late complication, it should be kept in mind in patients presenting with atypical thoracic pain and late-onset erythema of the surrounding skin.
(BELG J MED ONCOL 2022;16(1):37–40)
Read moreBJMO - volume 15, issue 7, november 2021
X. Mortiers MD, H. Vandeursen MD, PhD, T. Adams MD, T. Van den Mooter MD
Prostate cancer (PCa) is the most common cancer in men and the second leading cause of cancer death in men worldwide. Frequent metastatic sites of PCa are bone, lung, liver, pleura and adrenal gland. We hereby present a case of a 70-year old man with a history of prostate adenocarcinoma, treated with external beam radiotherapy, who consulted his urologist with a painful left hemiscrotum. An ultrasound showed a suspicious lesion in his left testis. Pathology of the orchidectomy specimen revealed a metastatic deposit of his prostate adenocarcinoma.
(BELG J MED ONCOL 2021;15(7):380-2)
Read moreBJMO - volume 15, issue 7, november 2021
A. Balland MD, P-A. Poncelet MD, L. Renard MD, N. Whenham MD
Glioblastoma rarely metastasise outside the brain. Mechanisms of distant dissemination are unclear, therapeutic options limited and prognosis poor. Here we report two cases of glial tumour with a secondary spinal spread. During their follow-up, patients developed neurological symptoms suggestive of a medullary affection. Diagnosis was based on spine MRI with demonstration of intramedullary or leptomeningeal enhancing lesions. Disease rapidly developed with an unfavourable outcome, despite oncological and best supportive treatments. We present a review of the literature focused on spinal dissemination of primary intracranial glioblastoma. We analyse the pathogenesis and the genetic mutations which might be involved. Finally, we discuss symptoms and possible treatments.
(BELG J MED ONCOL 2021;15(7):374-9)
Read moreBJMO - volume 15, issue 6, october 2021
S. Allaert , M. Bangia , K. Rans MD, C. Berghen MD, PhD, S. Joniau MD, PhD, G. Devos MD, PhD, H. Dumez MD, PhD, S. Jentjens MD, PhD, G. De Meerleer MD, PhD
This case report of an 80-year-old patient, who presented with up to six manifestations of oligorecurrent prostate cancer (PCa) over a time period of nine years, shows that repeated treatment with metastasis directed therapy (MDT) in this setting is feasible and nearly atoxic.
(BELG J MED ONCOL 2021;15(6):325-30)
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