ONCOCASE

Resection of two metachronous solitary pulmonary metastases of prostate cancer after radical prostatectomy: an exceptional case

A solitary pulmonary metastasis of prostate cancer is not considered a surgical lesion. However, growing evidence supports that highly selected patients could benefit from metastasectomy of a solitary pulmonary metastasis. We present an exceptional case of resection of two metachronous pulmonary metastases of prostate cancer after previous radical prostatectomy, resulting in nearly undetectable prostate-specific antigen (0.04 ng/ml).

(BELG J MED ONCOL 2014;8(5):217–9)

Subcutaneous panniculitis-like T-cell lymphoma in an elderly patient: a case report

We report a case of subcutaneous panniculitis-like T-cell lymphoma in an 84-year old woman admitted to the geriatric ward presenting with fever, loss of appetite and indurated lesions on the legs. Time from admission to diagnosis was seven weeks. Time from onset of first symptoms to diagnosis was four months. She was treated with systemic steroids with a good clinical response.

(BELG J MED ONCOL 2014;8(4):125–8)

Oligometastatic ovarian cancer successfully treated with stereotactic radiotherapy

A 53-year old woman presented with an ovarian cancer, FIGO stage IIIc, for which she received a (suboptimal) debulking. Chemotherapy was started, consisting of three-weekly carboplatin-paclitaxel. After four cycles, an interval-debulking was done, which revealed one positive lymph node (out of 21) located interaortocaval. Chemotherapy was resumed, until seven cycles. She had a complete remission, but after four years, she developed positive mediastinal and interaortocaval lymph nodes. She was treated with stereotactic radiotherapy, which resulted in resolution of the lesions and normalisation of the tumour marker. She has no signs of relapse after nearly two years.

This case illustrates that radiotherapy can be an important treatment option in selected patients with oligometastases.

(BELG J MED ONCOL 2014;8(3):87–90)

Bone lytic lesion: breast cancer metastase or sarcoidosis? A case-report

The authors present the case of a 47 year old woman with a history of a primary breast cancer and local recurrence, who developed disseminated pulmonary lesions, supra- and infra-diaphragmatic adenopathies and a lytic lesion of the right iliac bone nine years later. The diagnosis of disseminated carcinomatosis was initially suspected but a targeted bone biopsy surprisingly revealed the presence of sarcoidosis typical lesions. In this case, none of the sophisticated imaging tools could provide an accurate differential diagnosis. Thus for such cases, an anatomo-pathological analysis is definitively mandatory in order to avoid overtreating patients without evolutive cancer.

(BELG J MED ONCOL 2014;8(1):1–7)

What is your diagnosis?

(BELG J MED ONCOL 2014;8(1):21–2)

Myeloid sarcoma or lymphoblastic lymphoma? A closer look at the laboratory diagnosis

Summary

Although a myeloid sarcoma is a rare form of extramedullary leukaemia, its early diagnosis has been proven to be of utmost importance. Its presence is strongly related to the onset or the presence of systemic bone marrow leukaemia. However, the diagnosis of myeloid sarcoma is not straightforward. In the existing literature, approximately half of the cases of myeloid sarcoma were initially misdiagnosed as lymphoma. The current case reports details on the laboratory diagnosis of myeloid sarcoma in a 25-year old male. The laboratory presentation of myeloid sarcoma and the consecutive steps in order to correctly diagnose myeloid sarcoma using a variety of laboratory techniques including microscopy, flow cytometry and cytogenetics are highlighted.

(BELG J MED ONCOL 2013;7(4):119–22)

Case report: squamous cell carcinoma of the breast, a rare cancer?

Summary

We present the case of a 56-year old patient with primary squamous cell carcinoma of the breast. She underwent a radical mastectomy with adjuvant chemotherapy, consisting of carboplatinum and gemcitabine, and consecutive radiotherapy. Twenty-seven months after her treatment she is still disease-free. Hormonal therapy was initiated for a small tubular carcinoma and is continuing. As yet, there is uncertainty about the correct management of this rare and aggressive type of cancer, but there is growing evidence that adjuvant platinum-based regimens, especially cisplatinum, might be effective in inducing long-term complete remission.

(BELG J MED ONCOL 2013;7(3):89–92)