Erdafitinib in the Treatment of Metastatic Urothelial Carcinoma
Francisco Castro-Alonso, MD, and colleagues describe the effects of the use of erdafitinib in a patient with metastatic urothelial bladder cancer.
Metastatic Renal Cell Carcinoma With Sarcomatoid Features
In this installement of Clinical Quandaries, Abigail Mateos-Soria, MD, and colleagues present a case of an 38-year-old woman who has a 3-month history of fatigue, dyspnea, significant weight loss, and severe left flank pain.
Management of Residual Disease After First-line Chemotherapy in a Patient With a Nonseminomatous Germ Cell Tumor
In this edition of Clinical Quandaries, Regina Barragan-Carrillo, MD, and colleagues present a case of an 18-year-old man who has a 1-month history of nonpainful right testicular enlargement.
Sjögren Syndrome Induced by Immune Checkpoint Inhibitors in a Patient with Advanced Renal Cell Carcinoma
This clinical quandary details a Mexican man, aged 77 years, who presented to the oncology clinic with a sternal mass. Based on the results, the patient fulfilled the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for Sjögren syndrome, thus the diagnosis triggered by immune checkpoint inhibitors was definitively established.
Hand-Foot Skin Reaction Secondary to Sunitinib in a Patient With Metastatic Clear Cell Renal Cell Carcinoma
Another installment of Clinical Quandaries is presented by Karen Férez-Blando, MD, and colleagues of a 45-year-old man with a diagnosis of intermediate-risk stage IV clear cell renal carcinoma who develops grade 2 hand-foot skin reaction on sunitinib therapy.
Disorders of Sex Development and Malignant Germ Cell Tumors
Patients with disorders of sex development (DSDs) are at an increased risk of malignant germ cell tumors (GCTs).
In adulthood, the partial form of androgen insensitivity syndrome confers the greatest risk of developing malignant GCTs.
Gonadoblastoma is the most common gonadal GCT arising in patients with DSDs. Despite being a benign neoplasm, it can undergo malignant transformation in up to 60% of patients with a DSD.
Oncologic treatment in patients with disorders of sex development and malignant GCTs does not differ from the standard treatment for testicular GCTs.
Treatment of patients with DSDs requires a multidisciplinary team, including a psychiatric, genetic, and reproductive assessment as well as the involvement of an ethics committee.
An early diagnosis of DSDs is crucial to avoid the development of potentially serious complications in adulthood.
Challenges of Treating a Patient With Advanced Prostate Cancer During the COVID-19 Pandemic
Immune-Related Adverse Events Involving Multiple Organ Sites in a Patient Treated With Nivolumab Plus Ipilimumab
Experts discuss the case of a 56-year-old white man who presents with multiple immune-related adverse events
69-Year-Old Man With Castration-Resistant Prostate Cancer Progressing After Docetaxel and Androgen Receptor-Targeting Agent
Experts discuss the case of a 69-year-old man with a history of metastatic prostate cancer previously treated with androgen deprivation therapy with leuprolide.
What Are the Most Common Esophageal Metastases
A rare occurrence, cancer in the esophagus requires an individualized treatment plan.
What Are Treatment Options After Progression in PDL-1–Positive Metastatic Lung Adenocarcinoma after Chemo/IO?
What is the best treatment option after progression to chemotherapy/immunotherapy (chemo/IO) as first-line treatment for PD-L1–positive lung adenocarcinoma with no sensitizing mutations?
Diffuse Hepatic Infiltration by Metastatic Melanoma
Melanoma of the skin is the 19th most common malignant neoplasm worldwide, with 287,723 new cases estimated for 2018 and metastatic melanoma accounting for 4% of all new cases. In recent years, the prognosis of this stage has undergone a dramatic transformation with the advent of immunotherapy and BRAF/MEK targeted therapy.
Multiple Myeloma With Extramedullary Disease: A Challenging Clinical Dilemma
A 39-year-old woman with no significant medical history presented to the emergency department with progressive diffuse abdominal pain, involuntary weight loss, anemic syndrome, and limitation of mobility. What is the best treatment course to follow?
Initiation of ADT in a Man With Locally Advanced Prostate Cancer and Multiple Cardiovascular Risk Factors
A 65-year-old man presented with locally advanced, high-risk prostate cancer. His medical history was remarkable for type 2 diabetes mellitus, and he was an active smoker with a 27 pack-year history.
Is This Patient With Metastatic Bladder Cancer a Candidate for Second-Line Immunotherapy Treatment?
A 67-year-old man, a former smoker, presented with gross hematuria. A CT urogram showed a bladder tumor in the anterior wall and multiple enlarged retroperitoneal lymph nodes. Two vertebral metastases were seen on a bone scan. He underwent a transurethral resection of the bladder, and the pathology report revealed muscle-invasive urothelial carcinoma.
Man With Recurring Chordoma and Progressive Disease Despite Radiotherapy and Radical Resection
A 60-year-old man presented with lower limb claudication and a painful mass on his left buttock. Physical examination revealed a firm round mass, fixed to deep planes. A biopsy was performed and revealed a chordoma.
Man With Locally Advanced, High-Risk Prostate Cancer Asks About Adding Chemotherapy to His Treatment
A 55-year-old Hispanic male presents with a family history of gastric cancer in one sibling and prostate cancer in an older brother. CT performed in March 2015 for IMT surveillance showed a heterogeneous prostate with local invasion involving the bladder, seminal vesicles, and perirectal fat.
A Patient With Newly Diagnosed Metastatic Type 2 Papillary Renal Cell Carcinoma
A 42-year-old man presented with increasing right hip pain that limited his ability to walk. Magnetic resonance imaging (MRI) revealed a right lytic acetabular lesion. Further work-up included a computed tomography (CT) scan, which revealed an 8-cm left kidney tumor.
Biphenotypic Extramedullary Blast Crisis of Chronic Myeloid Leukemia With Variant Philadelphia Chromosome Translocation
A 45-year-old man with a known history of rheumatic fever and aortic valve replacement 15 years earlier presented with the chief complaint of a 1-month history of progressive, intense, nonmechanical lumbar pain.
Base of the Skull Metastases in Metastatic Castration-Resistant Prostate Cancer
A 63-year-old man with no family history of prostate cancer has prostate biopsy that revealed 9 out of 12 cores involved with prostatic adenocarcinoma, mostly Gleason score 5+4=9.
Visceral Metastases in Prostate Cancer: An Underestimated and Understudied Subgroup
While evidence points to benefit from highly active hormonal agents in prostate cancer with visceral involvement, the usefulness of immunotherapy is much less clear.
Pancreatic Metastases From Renal Cell Carcinoma Treated With Stereotactic Body Radiation Therapy
In this edition of our ongoing series, the authors present two cases involving renal cell carcinoma patients treated with SBRT for pancreatic metastases.
What Next? Choosing Second-Line Therapy in Progressive Renal Cell Carcinoma
A 71-year-old woman presented with back pain and was incidentally found to have a left upper pole renal mass. She underwent left open partial nephrectomy; the pathology results revealed a 2.2-cm clear-cell renal cell carcinoma (RCC) with negative margins and a Fuhrman nuclear grade of 2.
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