Mehmet Sitki Copur, MD, and colleagues examine the case of a 65-year-old patient with appendiceal mucinous neoplasms of the appendix who was treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
A 65-Year-Old Man With Back Pain and Imaging Findings of Spinal Cord Compression
Mehmet S. Copur, MD, and colleagues examine the case of a 65-year-old who presented with back pain and a large T8 spinal mass, leading to a diagnosis of multiple myeloma with spinal cord compromise.
ABSTRACT: Breast metastasis from extramammary malignancy is rare, with a reported incidence rate of 0.4% to 1.3% in the published literature. The primary malignancies that most commonly metastasize to the breast are leukemia, lymphoma, and malignant melanoma. Here, we report a very rare case of metastatic EGFR-mutated non–small cell lung cancer (NSCLC) in the breast detected by screening mammography. The patient had initially been diagnosed with a clinical stage IIIA NSCLC and had been treated with neoadjuvant chemoradiation followed by curative-intent surgery. Several interesting aspects of the case, along with a discussion of evolving adjuvant and frontline metastatic management options in EGFR-mutated NSCLC, will be presented.
Locally Advanced Gastrointestinal Stromal Tumor in a 33-Year-Old Woman Seeking to Conceive
ABSTRACT Gastrointestinal stromal tumors (GISTs) are rare neoplasms of the gastrointestinal tract. They commonly present with nonspecific symptoms and thus are often discovered incidentally. They are best identified by CT scan and most stain positive for CD117 (C-Kit), CD34, and/or DOG-1. Several risk stratification classification systems have been developed based on tumor size, mitotic rate, location, and perforation. Traditional chemotherapy and radiation therapy have been very ineffective, making surgery the mainstay of treatment. The discovery of mutations associated with these tumors has revolutionized the treatment approach. Imatinib mesylate, a selective tyrosine kinase receptor inhibitor, used as adjuvant or neoadjuvant therapy, has greatly improved the morbidity and mortality associated with GISTs. As the survival of patients has increased with the long-term use of targeted therapies, quality-of-life issues now have become much more relevant and have come to the forefront of care. We present a young woman who was successfully treated for GIST but now faces associated long-term adverse effects of imatinib, including the challenge of preserving fertility and the potential for childbearing.
Ineptitude of Clinical Trials System Highlighted by COVID-19 Pandemic
July 15th 2020The coronavirus disease 2019 (COVID-19) pandemic has permanently changed many aspects of clinical care, including clinical trials. A short list of the challenges faced by the entire research community during this pandemic include (but aren’t limited to) enrollment and protocol adherence difficulties, needing to reduce patient visits, staffing constraints, and limited availability of ancillary services.
A 51-Year-Old Male With Abdominal Distention, Pain, and A Retroperitoneal Mass
August 14th 2019A 51-year-old man noticed abdominal swelling and distention with intermittent abdominal pain, early satiety, and decreased appetite over the past several months. A computed tomography scan of the abdomen is performed. What's your diagnosis?
Quiz: Best Second-Line Tx for Metastatic Lung SCC and Crohn Disease?
March 1st 2018Are there special second-line considerations for an SCC lung patient with a history of Crohn disease who progressed on first-line carboplatin and gemcitabine? Can any pretreatment tests be deferred for a patient with a history of heavy smoking and a single solitary nodule found on his CT chest scan? Take this multiquestion quiz to find out.
Woman With Rare Cause of Rectal Bleeding
January 15th 2018A 56-year-old Caucasian woman presented to her primary care physician with a 3-month history of intermittent bright red rectal blood with defecation. At her initial visit, a digital rectal examination, anoscopy, and a pelvic examination with DNA testing for high-risk HPV were performed; all results were negative. She was referred for a colonoscopy, which revealed an abnormal area with a 3 × 4–cm mass in the rectum at a distance of 10 cm from the anal verge.
Quiz: How Common Are ROS1 Rearrangements in Patients With Lung Cancer?
January 1st 2018In patients with stage IIIA non–small-cell lung cancer, should the presence of N2 disease be determined by both radiologic and invasive staging prior to treatment initiation? Are ALK rearrangements and EGFR mutations mutually exclusive? Test your knowledge in our latest quiz.
Quiz: Know When to Use SBRT in Lung Cancer?
December 1st 2017Do you know what available options exist for a lung cancer patient with a BRAF V600E mutation? How about the best course of action for a patient with T2N2M0 disease? Test your knowledge and take part in a series of case scenarios to see if you can pick the correct course of action for each.
Does Everolimus in Gastrointestinal, Lung NETs Delay Progression at Expense of Health-Related QOL?
October 1st 2017Do you know the quality-of-life impact of everolimus in gastrointestinal or lung neuroendocrine tumors? Do you know the associations between neuroendocrine tumors and MEN1? Test your knowledge on these topics and more in our latest quiz.
Chest X-Ray Reveals Large Pleural Mass
September 15th 2017A 70-year-old woman with no history of smoking or asbestos exposure presented with dyspnea on exertion, nonproductive cough, left-sided pleuritic chest pain, and fatigue. Chest radiography revealed a large left pleural effusion and a mass in the left lower lobe. What is the diagnosis?
Test Your Knowledge of Neuroendocrine Tumors
September 1st 2017Are you up to date on staging for neuroendocrine tumors/carcinoid tumors? How about which follow-up tests are most appropriate for a patient with medullary thyroid carcinoma? Test your knowledge on these topics and more in our latest quiz.
Which Histopathologic Subtype of Ovarian Cancer is Most Common?
September 1st 2017Do you know which histopathologic subtype of ovarian cancer is most common? Or the appropriate management of a patient with clear cell carcinoma confined to the left ovary? Take this quiz to test your knowledge on the management of ovarian cancer.
Patient Presents With Eye Redness, Fleshy Overgrowth of the Bulbar Conjunctiva
August 4th 2017A 66-year-old woman presented with conjunctival redness and irritation of the right eye. An eye exam revealed a painless, pink, fleshy patch with a smooth surface in the superior aspect of nasal bulbar conjunctiva of the right eye. A biopsy of the lesion was performed. What is the diagnosis?
Persistent Erythematous Papular Lobulated Masses on Patient’s Nose
May 5th 2017A 90-year-old man presented with a 6-month history of swelling and redness of his nose. He had persistent erythematous macules, plaques, and partially confluent nodules with irregular borders developing on his nose over the past 6-month period. What is your diagnosis?
Synchronous Bilateral Breast Cancer With Discordant Histology
April 15th 2017A 48-year-old Caucasian woman presented with a palpable right breast mass. Physical examination confirmed a lump on the upper outer quadrant of her right breast. On PET/CT scan there was an incidental finding of increased metabolic activity in the left lateral breast.