BJMO - 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)
Read moreBJMO - volume 15, issue 6, october 2021
J. De Man MD, M. Schroeven MD
A 56-year old female presenting with neurological dysfunction is diagnosed with a voluminous cerebral tumour. After complete resection of the lesion, histopathological examination strongly suggests a metastasis of a small cell lung carcinoma. However, extensive work-up showed no evidence for extracerebral primary tumour. Adjuvant treatment was consistent with radiotherapy and cisplatin-based chemotherapy. After five years the patient is doing well without evidence of recurrence. We present the difficult differential diagnosis between a primary brain small cell carcinoma and an occult small cell lung carcinoma. Extrapulmonary small cell cancer (EPSCC) is a distinct clinicopathological entity compared to SCLC, but because of the low incidence, it is often managed in the same way as SCLC. More clinical knowledge based on retrospective analyses and biological insights is required to determine the best therapeutic approach. In any case, it is important to interpret immunohisto-chemical findings with caution in different clinical situations.
(BELG J MED ONCOL 2021;15(6):321-4)
Read moreBJMO - volume 15, issue 4, june 2021
S. Wautier MD, C. Mahiat MD, T. Connerotte MD, PhD, N. Whenham MD, R. Poncin MD, L. Duck MD
Haemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease characterised by cytotoxic immune deregulation leading to hypercytokinaemia and macro-phage activation. Given the high mortality rate, HLH must be suspected in nonspecific situations and promptly confirmed based on 2004-HLH criteria. In adult patients, HLH is usually secondary to infection, malignancy or underlying autoimmune diseases. As treatment, paediatric protocol consists of immuno-therapy and chemotherapy, followed by a haematopoietic stem cell transplant (HSCT). In adults, individualised modified treatment is recommended because of the variable cause and severity of situation. Corticosteroids are the mainstay. We report the case of a patient with breast cancer, for whom we made the diagnosis of HLH during her neoadjuvant chemotherapy based on the 2004-HLH criteria. A viral aetiology was suspected with reactive lymphocytes found on the blood smear, and we promptly initiate treatment of dexamethasone. Our patient fully recovered both from her HLH and breast cancer.
(BELG J MED ONCOL 2021;15(4):186-91)
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