ONCOCASE

Renal mass in a patient with invasive lobular adenocarcinoma

SUMMARY

Breast cancer often metastasises to bone, lymph nodes, liver and lung. In this case report, we present a 75-year-old woman with a suspicious mammography and ultrasound of the breast who had a synchronous painless renal lesion. On computed tomography, the renal mass was suspected of being a primary lesion of the renal pelvis, but anatomopathological examination of the nephro-ureterectomy specimen revealed that it was a metastatic deposit of invasive lobular adenocarcinoma of the breast.

(BELG J MED ONCOL 2019;13(4):132–134)

Tumoral melanosis associated with ipilimumab plus nivolumab-treated metastatic melanoma: A case report and review of the literature

SUMMARY

Tumoral melanosis can be a manifestation of completely regressed melanoma that presents as a possibly suspicious pigmented lesion, with histology showing dense infiltration of benign melanophages. This case report describes a unique case of a 32-year-old carpenter diagnosed with a metastasis located at the gastric fundus, three years after primary diagnosis of a malignant melanoma at the right shoulder. Despite the fact that combined immunotherapy with ipilimumab plus nivolumab could only be administered once due to the development of severe colitis grade 2-3, a control gastroscopy after four months reveals macroscopic alteration of the gastric metastasis with histological regression to benign tumoral melanosis.

(BELG J MED ONCOL 2019;13(3):106–109)

Primary squamous cell carcinoma of the male posterior urethra: a rare urogenital malignancy

Primary urethral cancer is an extremely rare and aggressive malignancy. Due to its rarity and the lack of large prospective trials, no standardised treatment protocols are currently available, and treatment decisions are most often made on a case-to-case basis. We present the case of a 62-year-old male with squamous cell carcinoma of the posterior urethra treated at our institution followed by an in-depth discussion on presentation, diagnosis and treatment of this rare cancer.

(BELG J MED ONCOL 2019;13(1):27–30)

Four case reports of arterial thromboembolism and cisplatin administration

Cisplatin is one of the frequently used chemotherapeutic agents. Common side effects such as vomiting, nephrotoxicity, ototoxicity and neurotoxicity are well known, though Cisplatin is also thought to activate destructive processes in blood vessels, including all types of arteries. Not only can it cause long-term cardiovascular complications (myocardial infarction, hypertension, and stroke), but also such complications during or shortly after its systemic administration. In a significant portion of patients, with up to 9% in some studies, thromboembolic events are encountered.^1,2 In most of the cases, this concerns a venous thromboembolic event, though arterial thromboembolic events should not be neglected as it predicts a bad prognosis and significantly increased mortality risk, especially in cancer patients receiving other prothrombotic chemotherapies or when certain comorbidities are present that enhance the risk of thromboembolism.³ During a short period, we encountered four patients with arterial thromboembolic events while receiving Cisplatin-based therapy, of which three patients had a renal infarction. It should be noted that each patient had a different type of malignancy and Cisplatin was administered in combination with other therapeutic agents.

(BELG J MED ONCOL 2018:12(3):125–129)

Primary leiomyosarcoma of the thyroid: case report and review of the literature

Summary

Primary leiomyosarcoma of the thyroid is a very rare tumour with an unfavourable prognosis. We present a sixty-year-old woman with a localised primary thyroid leiomyosarcoma. Despite a complete resection, a recurrence of the tumour was noticed six months later. After induction chemotherapy with ifosfamide and doxorubicin, the patient had renewed extensive surgery with removal of a tumour remnant and several lymph nodes. This was followed by radiotherapy. Eighteen months after diagnosis the patient is still alive and free of tumour on PET-CT. The case illustrates the high recurrence potential of a primary thyroid leiomyosarcoma despite a complete initial resection, but also the success of aggressive combined treatment.

(BELG J MED ONCOL 2018;12(2):75–78)

Acute cerebral toxicity during concurrent anti-HER2 therapy and radiotherapy for breast cancer brain metastases

Summary

Patients with HER2-positive advanced breast cancer frequently develop brain metastases. Dual anti-HER2 therapy significantly prolongs survival in previously untreated metastatic disease. However, no safety data exist on the concurrent use of pertuzumab, trastuzumab and brain radiotherapy. We describe two cases of previously untreated HER2-positive breast cancer and brain metastases, who developed acute cerebral toxicity during the concomitant administration of anti-HER2 therapy and whole-brain radiotherapy. Systematic clinical data is warranted to prove the safety of this association.

(BELG J MED ONCOL 2018;12(1):22–25)

TPFE (docetaxel, cisplatin, 5-FU and cetuximab) for recurrent mucoepidermoid carcinoma of the parotid gland: an aggressive strategy for an aggressive disease

SUMMARY

The prognosis of patients with advanced malignant salivary gland cancer is usually poor. Systemic therapy combined with best supportive care is recommended for patients with metastatic or recurrent advanced salivary gland cancer ineligible for surgery or radiotherapy. Sensitivity to chemotherapy is thought to be histotype specific. However, to date, none of the systemic therapies, whether cytotoxic or non cytotoxic, can be considered standard for these tumours.

We report the case of a 43 year-old male patient with a third (loco)regional recurrence and metastases in lymph nodes below the clavicles of a mucoepidermoid carcinoma of the right parotid gland. He participated in a feasibility study and was treated with 3-weekly cycles of docetaxel, cisplatin, 5-fluorouracil plus weekly cetuximab (TPFE). After four TPFE cycles, additional radiation was given to the left neck. A complete response was reached which is ongoing for ten years. TPFE induced acute toxicities: skin rash grade 3, hypotension grade 3, neutropenia grade 3, anaemia grade 2 and alopecia grade 2. This observation underlines the importance of offering patients the possibility to participate in clinical trials. International collaboration for rare head and neck cancers, such as mucoepidermoid carcinoma, is urgently needed.

(BELG J MED ONCOL 2017;11(8):386-392)