BJMO - volume 11, issue 6, october 2017
G. El Hachem MD, C. Jungels MD, R. De Wind , J. Kerger MD
Uterine carcinosarcomas or mixed malignant mullerian tumours (MMMT) are rare gynaecological tumours with mixed carcinomatous and sarcomatous components. They are aggressive with a high risk of loco-regional and distant recurrence. Central nervous system (CNS) invasion by gynaecological malignancies is unusual and is exceptional in MMMT. There are eight reported cases of CNS metastases secondary to uterine MMMT with six cases of brain and two cases of spinal cord metastases. Here we report the case of a 50 year old woman, previously healthy, who was diagnosed with an aggressive heterologous 17x14x10 cm MMMT of the uterus, invading the whole endometrial wall, with lympho-vascular invasion and associated rhabdomyosarcoma elements. She underwent radical surgical resection followed by adjuvant radiation and chemotherapy. She recurred for the first time locally, and was treated with wide surgical resection. Six months later, she developed metastases in supra and infra-diaphragmatic lymph nodes, peritoneum and lungs. While being on palliative chemotherapy for her disseminated disease, she suffered from headache, and unfortunately 4 brain metastatic lesions were seen on brain MRI. Clinicians must be aware of this exceptional metastatic location of MMMT. However, there are no guidelines to screen, prevent or treat CNS metastases secondary to MMMT.
(BELG J MED ONCOL 2017;11(6):284–288)
Read moreBJMO - volume 11, issue 3, may 2017
C. Wachters MD
Introduction: primary breast lymphoma is a rare malignancy representing less than 1% of all tumours presenting in the breast.
Case report: a 64 year-old woman presented with altered mental status due to severe hypercalcemia and was found to have a large breast mass with lytic bone lesion of the skull. Biopsy of the mass revealed double hit lymphoma.
Conclusion: we discuss a rare case of breast malignancy with atypical clinical presentation and the literature concerning the characteristics and therapeutic options available for double hit lymphomas.
(BELG J MED ONCOL 2017;11(3):122–125)
Read moreBJMO - volume 11, issue 1, february 2017
C. Quaghebeur MD, N. Whenham MD, J.P. Machiels MD, PhD, J-P. Haxhe MD, A-P. Schillings MD, E. Laterre MD, X. Catteau MD, R. Poncin MD, L. Duck MD
Breast phyllodes tumours account for less than 0.5% of breast tumours, their diagnosis is therefore often made after pathological exam. They are fibroepithelial lesions of the breast, and are classified as benign, borderline or malignant. For malignant phyllodes tumours, aggressive behaviour with risk of local and distant recurrence may be seen. Therefore, at least one centimetre free-margins, or mastectomy, should be preferred for local malignant tumours. No prospective randomised data exist to elucidate the role of adjuvant chemotherapy, but radiotherapy should probably be offered after breast conservative surgery for borderline and malignant tumours. For metastatic disease, there is no standard chemotherapy regimen. Doxorubicin is the main recommended drug, based on scarce data. Palliative surgery or radiotherapy may also be offered. We present here a patient with lung metastatic disease who partially responded to a platin-etoposide regimen after doxorubicin failure, and make a short review of the literature.
(BELG J MED ONCOL 2017;11(1):26–28)
Read moreBJMO - volume 10, issue 7, november 2016
K. Oualla MD, M. Aoun MD, M. Lemort MD, A. Harrouk MD, S. Latifyan MD, A. Awada MD, PhD, A. Georgala MD
Progressive multifocal leukoencephalopathy is a rare demyelinating condition caused by reactivated JC polyomavirus. This disease occurs mainly in the context of immunodeficiency, usually from human immunodeficiency virus.We report a case of 67 years old patient, treated for metastatic nasopharyngeal epidermoid carcinoma with three lines of chemotherapy, admitted for deterioration of performance status and neurological symptoms represented by agitation, cognitive decline complicated by loss of consciousness, after receiving three cycles of carboplatin-docetaxel. Cerebral imaging had strongly suspected brain metastases given to the context of metastatic neoplasm in progression but cerebrospinal fluid was positive for JC-BK Polyomavirus. Unfortunately, evolution was marked by rapid clinical deterioration leading to death. We report this case in order to underline the rarity of this disease, clinico-radiological features, especially misleading appearance with cerebral metastases, risk factors and prognosis.
(BELG J MED ONCOL 2016;10(7):276–280)
Read moreBJMO - volume 10, issue 6, september 2016
F. Baekelandt MD, W. Everaerts MD, PhD, M. Albersen MD, PhD, B. Van Cleynenbreugel MD, PhD, U. Milenkovic MD, C. Assenmacher MD, S. Joniau MD, PhD
BRCA2 mutation carriers generally present with prostate cancer at a younger age, with more aggressive disease and with a higher risk of nodal involvement or distant metastases at diagnosis. We present a patient with metastatic castrate resistant prostate cancer with a BRCA2 gene mutation and its clinical significance for daily practice.
(BELG J MED ONCOL 2016;10(6):223–227)
Read moreBJMO - volume 10, issue 3, may 2016
R. Peric MD, J.G. Aerts MD, PhD
This case report describes a patient referred with apparent stage IV non-small-cell lung cancer. There was doubt about the nature of the two processes in both lungs. Interpretation of radiological images and (the decisions around) acquiring histological evidence proved to play a pivotal role in definitive staging and treatment.
(BELG J MED ONCOL 2016;10(3):101–104)
Read moreBJMO - volume 10, issue 2, april 2016
B. Dekeyser MD, M. Haagdorens MD, I. Deleu MD, E. Van Hul MD, E. Beerens MD, D. Van der Planken MD, K. Hendrickx MD, L. Verstraeten MD, Y. Geussens MD, W. Lybaert MD
A 54-year old man presented with a new-onset headache, phonophobia, tinnitus, blurred vision, and nausea. Further imaging and histological examination confirmed the diagnosis of an olfactory neuroblastoma. Olfactory neuroblastoma or esthesioneuroblastoma is a rare type of cancer, originating from the basal stem cells of the olfactory epithelium in the nasal cavity. The patient received a maximal possible surgical resection of the tumour, followed by adjuvant chemo-irradiation. Given the absence of neck metastases, no prophylactic treatment of the neck was done. Recent studies state that standard treatment of esthe-sioneuroblastoma consists of surgical resection, followed by local radiotherapy. Adjuvant chemotherapy is recommended for the locally advanced tumours. As for the treatment of the neck, current consensus is to perform salvage therapy when neck metastases are present.
(BELG J MED ONCOL 2016;10(2):69–72)
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