We describe a case of isolated primary CNS lymphomatoid granulomatosis and a discordant low-grade B-cell lymphoma involving the bone marrow causing chronic immune thrombocytopenia. Clinical course was complicated with disseminated zoster and sub-massive pulmonary embolism. Our patient was successfully managed with a combination radioimmunotherapy strategy with rituximab and radiation therapy.

To date, there is no report on the subsequent development of AITL in patients with EBV-positive DLBCL. We performed a rare case of EBV-positive AITL developing one year after initial diagnosis of EBV-positive DLBCL. The patient showed poor response to the chemotherapy regimen, and poor surviva

Imatinib is used as first-line treatment for chronic myeloid leukemia (CML) even in patients with impaired renal function. We successfully used therapeutic drug monitoring to determine the dose for re-administration of imatinib in a CML patient who initiated dialysis for acute renal dysfunction associated with the initial imatinib therapy.

Background: To describe how parents and families of children with cancer evaluate the benefits and risks of using social media (SM) and how they navigate disagreements between oncologists’ advice and information found on SM. Procedure: Parents of children who had been previously diagnosed with cancer, and who had used SM for a purpose related to that child’s health were recruited through SM sites and nonprofit organizations across the U.S. and were invited to complete questionnaires about their experiences using SM; a subset of participants also completed a follow-up in-depth interview. Open-ended responses and interviews were analyzed using thematic analysis. Results: 90 parents completed written questionnaires; 21 completed follow-up interviews. 70% described experiencing a situation in which information shared on SM conflicted with information provided by their child’s oncologist. Although 86% discussed it with the oncologist and 70% described the response as positive, 78% retained negative feelings about the experience. Openness to discussing SM, honesty, transparency and humility regarding the limits of medicine, and shared decision-making regarding information found on SM were connected with reported trust in the oncologist. Conclusions: Parents offered valuable insights regarding their experiences navigating SM, including 8 recommendations for how pediatricians might approach discussing parental SM use. Future studies will evaluate the utility of these recommendations for pediatric clinicians.

Amyloid arthropathy is often underdiagnosed. The articular forms of AL amyloidosis may mimick the rheumatoid arthritis. The presence of macroglossia should draw attention to chronic polyathralgia.

Doege Potter syndrome is a rare paraneoplastic clinical entity. A 31-year-old woman consulted with a right indurated malar mass and hypoglycemia. Blood test showed a non-insulin-mediated hypoglycemia. CT scan revealed a solid tumor from the right temporal region with liver metastasis. The histopathological diagnosis revealed a solitary fibrous tumor.

We described an atypical presentation of papillary thyroid cancer metastasized to left finger. This case highlights the importance of an early and effective engagement of multidisciplinary team approach with family in order to optimize patient care.

Primary effusion lymphoma (PEL) is a distinct disease entity of large B-cell lymphomas most often occurring in immunocompromised patients. We present a rare case of extracavitary PEL primary to the bone marrow in a HIV-positive patient.

Lorlatinib is a third-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) designed to penetrate the blood brain barrier. We report 2 cases of patients with ALK-rearrangement non-small cell carcinoma associated with severe symptomatic CNS metastases and poor performance status. Treatment with lorlatinib improved their neurological condition and performance status.

The association of Daunorubicin and Steven-Johnson Syndrome (SJS) has not been well-established. In this report, we describe a fatal case of a 2 years old boy with acute leukemia who developed Steven-Johnson Syndrome owing to Daunorubicin. Clinicians should consider the possible association of Daunorubicin with SJS.

Background and purpose: Paclitaxel is a widely used anti-neoplastic agent but has low oral bioavailability due to gut extrusion by P-glycoprotein (P-gp). Oral paclitaxel could be more convenient, less resource intensive, and more tolerable than intravenous administration. Encequidar (HM30181A) is a novel, minimally absorbed gut specific P-gp inhibitor. We tested whether administration of oral paclitaxel with encequidar (oPac+E) achieved comparable AUC to intravenous paclitaxel (IVP) 80mg/m2. Experimental approach: We conducted a multi-centre randomised crossover study with two treatment periods. Patients (pts) with advanced cancer received either oral paclitaxel 615mg/m2 divided over three days and encequidar 15mg orally one-hour prior, followed by IVP 80mg/m2, or the reverse sequence. PK blood samples were taken up to day 9 for oPac+E and day 5 for IVP. Key Results: 42 pts were enrolled; 35 completed both treatment periods. AUC0-∞was 5033.5 +/- 1401.1 ng.h/mL for oPac+E and 5595.9 +/- 1264.1 ng.h/mL with IVP. The geometric mean ratio (GMR) for AUC was 89.5% (90% CI 83.9-95.5). Mean absolute bioavailability of oPac+E was 12%. PK parameters did not change meaningfully after 4 weeks administration of oPac+E in an extension study. G3 treatment emergent adverse events occurred in 7 (18%) pts with oPac+E and 2 (5%) with IVP. 75% of pts preferred oPac+E over IVP. Conclusion and Implications: GMR for AUC was within the predefined acceptable range of 80%-125% for demonstrating equivalence. oPac+E is tolerable and there is no evidence of P-gp induction with repeat administration. With further study, oPac+E is a candidate to replace IVP.

Medullary and papillary thyroid carcinoma are two distinct neoplasms. Its simultaneous is uncommon and its occurrence as a mixed follicular medullary carcinomas is extremely rare. We present a 60-year-old man with the mixed medullary-papillary carcinoma of the thyroid and papillary and medullary component metastases on lymph nodes.

Some of the commonly prevalent malignancies may rarely metastasize to aberrant locations in the body. Such cases have not been described adequately in the literature. Two cases presented here show unusual sites of spread, not congruent with present knowledge of metastasis.

We present a patient with 3 separate primary cancers over the course of 11 years: Follicular Lymphoma, Abdominal mesothelioma and Rectal Adenocarcinoma respectively Multiple primary malignancies are exceedingly rare but they may occur sequentially in a patient. Peritoneal mesothelioma known as a fatal malignancy may completely regress with chemotherapy.

To date, there have only been 46 patients reported in the literature with trisomy 18 and hepatoblastoma. We describe the case of an 11-month-old female with trisomy 18 and hepatoblastoma who was successfully treated by pairing surgical resection with a modified chemotherapy regimen omitting doxorubicin given her underlying cardiac abnormalities. Our case successfully demonstrates how chemotherapy regimens can be modified to accommodate for other underlying abnormalities and emphasizes that routine screening guidelines should exist for patients with trisomy 18 to allow for earlier detection and treatment.

Background: To assess the efficacy and prognosis of computed tomography (CT)-guided 125I radioactive seeds implantation brachytherapy (RSI-BT) for recurrent nasopharyngeal carcinoma (NPC) after external beam radiotherapy (EBRT). Methods: Thirty-one patients with recurrent NPC (forty-one lesions) after EBRT from February 2003 to January 2019 were enrolled in this retrospective study. The work-follow of CT-guidance RSI-BT was: indication selection, patient set-up and immobilization on CT couch, CT-simulation, preoperative planning, prescription doses (PD) definition of 110-160Gy, seed implantation, postoperative dosimetric evaluation and postoperative follow-up. Median radioactivity of RSI was 0.43 (range 0.22-0.79, average 0.61) mCi. Median actuarial number of 125I seeds was 24 (range 3-83, average 37). Median value of post-operative D90 was 118.5 (range 62.4-246, average 136.2) Gy. Local control (LC) and overall survival (OS) were investigated for their relationship with the prognosis. The adverse events were evaluated by the Radiation Therapy Oncology Group (RTOG) classification criteria. Results: Median follow-up was 41.9 (range 2.1-60.2, average 44.1) months. Median LC was 35.8 (range 2.1-60.2, average 34.9) months. LC at 1-, 3- and 5-year was 71.3%, 41.9% and 27.9%, respectively. Median OS was 22.6 (range 2.1~60.2, average 27.1) months. OS at 1-, 3- and 5-years was 57.7%, 23.8% and 11.9%, respectively. Univariate analysis suggested that sex (P=0.037) and frequency of previous EBRT (P=0.001) were prognostic factors influencing LC. Moreover, univariate analysis also suggested that frequency of previous EBRT (P=0.012) was prognostic factors influencing OS. Prevalence of side effects (≥grade 3) was 6.5%. Conclusion: 125I RSI-BT was a safe and feasible salvage treatment for recurrent NPC after EBRT. Key words: recurrent nasopharyngeal carcinoma; External beam radiotherapy; 125I seed implantation brachytherapy; overall survival; local control; side effects.

A document by Jonathan Marron, written on Authorea.

Patient with a long history of CLL and known trisomy 12 presented with rapidly rising lymphocytosis, bulky adenopathy, and splenomegaly. Peripheral blood and bone marrow exam showed preponderance of prolymphocytes. Cytogenetic analysis showed an abnormal male karyotype with trisomy 12 and a new t(8;21) translocation in the same 6 metaphases.

Giant cell arteritis (GCA) is rarely associated with cancer. The association paraneoplastic vasculitis and tumors appears to be more frequent with hematologic cancers. The authors report the case of 83-years-old Caucasian man, diagnosed with prostatic adenocarcinoma who developed a paraneoplastic GCA responsive to corticosteroids associated with disease progression.

This is the first report using an anti-tumor drug called Pazopanib for a case of solitary fibrous tumor that occurred in the ear canal. Pazopanib will be useful for clinicians involved in this case in the future, we have reported the detailed progress and immunological analysis.

We report a 64-years old man with B-cell CLL infected by SARS-CoV-2 during his hospitalization for a spondylodiscitis. Because of his health conditions the duration of the antiviral therapy was restricted to one week where we observed a transient disappearance of CD19+/CD5+ B-lymphocytes in peripheral blood.

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) of the breast is rare. We report a 59-year-old female with remote history of ductal carcinoma in situ treated with radiation and tamoxifen, who was recently diagnosed with CLL/SLL of contralateral breast after a localized suspicious cluster of masses was detected on routine mammography.

Solid Pseudopapillary Tumors of the Pancreas (SPTPs) are rare tumors with non-specific presentation which makes them a difficult diagnostic challenge. In our case the morphologic features of the tumor cells were similar to the cells seen in neuroendocrine tumors. The final diagnosis was made based on the results of Immunohistochemistry which cleared up the doubts and made SPTP the definitive diagnosis.

Bacillus Calmette-Guérin (BCG) is commonly used in treating superficial urothelial carcinoma. Though rare, local and systemic disseminated BCG infections are important to recognize as they require prolonged antimicrobial therapy and surveillance. We present an unusual case of a parapharyngeal space mass as manifestation of disseminated BCG following urothelial carcinoma treatment.