Management of Residual Disease After First-line Chemotherapy in a Patient With a Nonseminomatous Germ Cell TumorDecember 17th 2021
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.
Initiation of ADT in a Man With Locally Advanced Prostate Cancer and Multiple Cardiovascular Risk FactorsMay 15th 2018
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.
Metastatic Relapse After Initial Clinical Stage I Testicular Leydig Cell TumorMarch 15th 2014
A 70-year-old, otherwise healthy man presented to his primary care provider for an annual checkup, at which time a nontender right testicular mass was noted. He denied any symptoms, and his serum alpha-fetoprotein and beta-human chorionic gonadotropin levels were normal.
Sequencing Medical Therapy in Prostate Cancer: Not as Easy as 1-2-3November 15th 2013
With the emergence of several new agents for the treatment of advanced prostate cancer, new questions have arisen regarding the optimal sequence or combination of these agents. As we await the results of ongoing and planned clinical trials to answer some of these questions directly, the decision-making process will rely heavily on considerations of side effects and patient characteristics.
Optimizing Outcomes of Advanced Prostate Cancer: Drug Sequencing and Novel Therapeutic ApproachesJanuary 17th 2012
We have entered a period of accelerated drug development and optimism in the care of advanced prostate cancer. The treatment paradigm for these patients is rapidly evolving, with future study needed to define the optimal sequencing and potential combinations of these new agents.
A Rare Case of Metastatic Renal Epithelioid AngiomyolipomaAugust 15th 2011
The patient is a 43-year-old man who was initially evaluated at an outside institution for unexplained anemia and who was found to have a large right kidney mass. He underwent a radical nephrectomy for a 19-cm large-cell, poorly differentiated neoplasm, consistent with pleomorphic, epithelioid angiomyolipoma (EAML) with extensive necrosis and cytologic atypia.
A Renaissance in the Medical Treatment of Advanced Prostate CancerDecember 15th 2010
Prostate cancer will be diagnosed in one of six men during their lifetimes, and a small portion of these will progress after primary and salvage therapies. For many years, there were few treatment options for these patients after routine hormonal maneuvers, and standard of care since the early 2000s has consisted primarily of docetaxel, which improved survival over the previous first-line therapy mitoxantrone. In recent years, however, new therapies have begun to emerge to treat this devastating form of prostate cancer. This review examines the mechanisms behind these therapeutics and the key trials seeking to validate their clinical use.
A Young Woman With Multiple Kidney LesionsMarch 22nd 2010
The patient is a 26-year-old woman with a complex oncologic history. At 1 year of age, she was diagnosed with a stage III abdominal neuroblastoma, which was treated, and again at age 9, she had a recurrence of neuroblastoma in the left axilla. She was in her usual state of good health until 18 months ago, when she presented with hematuria and was found to have a right-sided kidney mass.
Recurrent Urothelial Carcinoma With Pulmonary MetastasisDecember 16th 2009
A 56-year-old woman was referred to our institution for a left nephroureterectomy after the diagnoses of a nonfunctioning left kidney and noninvasive papillary urothelial carcinoma of the distal left ureter (Ta grade 1). Following the procedure, surveillance cystoscopy and computed tomography (CT) scan of the abdomen and pelvis demonstrated a large bladder tumor with pan-urothelial extension.
A Man With Changes in the Urinary Bladder: Benign Metaplasia or Adenocarcinoma?February 19th 2009
The patient is a 39-year-old man who presents with pelvic lymphadenopathy. He has a history of ureteral reflux disease, recurrent nephrolithiasis, right nephrectomy, ileal loop diversion of the left ureter, and radical cystectomy for “bladder cancer,” which he underwent 3 years ago. The lymphadenopathy was discovered incidentally during recent imaging.