ABSTRACT
CASE: A 13-year-old adolescent boy visited our hospital with a growing mass on his left leg. Investigations and examinations were performed to obtain a final diagnosis of Ewing sarcoma in the head of the left fibula with lung metastasis. Neoadjuvant chemotherapy was extended to 11 courses with radiation before wide tumor resection could be performed. The final 3 adjuvant chemotherapy courses were administered to complete the original protocol while surgical resection complications were also treated. The pathological report revealed free margin resection with nonviable tumor cells. CONCLUSION: An extended neoadjuvant chemotherapy regimen with additional radiation therapy for Ewing sarcoma provided extra local control and allowed limb salvage.
Subject(s)
Bone Neoplasms , COVID-19 , Sarcoma, Ewing , Male , Adolescent , Humans , Sarcoma, Ewing/drug therapy , Sarcoma, Ewing/surgery , Sarcoma, Ewing/pathology , Neoadjuvant Therapy , Bone Neoplasms/drug therapy , Bone Neoplasms/surgery , Bone Neoplasms/pathology , Chemotherapy, AdjuvantABSTRACT
The interaction of coronavirus disease-2019 (COVID-19) and chemotherapy may result in worse outcomes. However, there may be more indirect effects of COVID. We report 3 cases in which treatment was delayed because of COVID-related inability or reluctance to travel. Oncology programs should consider such indirect effects when devising treatments.
Subject(s)
COVID-19/transmission , Osteosarcoma/drug therapy , Retinoblastoma/drug therapy , SARS-CoV-2/isolation & purification , Time-to-Treatment/statistics & numerical data , Transportation/statistics & numerical data , Antineoplastic Combined Chemotherapy Protocols , Bone Neoplasms/drug therapy , Bone Neoplasms/virology , COVID-19/virology , Child , Child, Preschool , Female , Humans , Infant , Male , Osteosarcoma/virology , Prognosis , Retinal Neoplasms/drug therapy , Retinal Neoplasms/virology , Retinoblastoma/virologyABSTRACT
INTRODUCTION: Favipiravir is an antiviral agent that is recently used for SARS-CoV2 infection. The drug-drug interactions of favipiravir especially with chemotherapeutic agents in a patient with malignancy are not well known. CASE REPORT: The patient diagnosed with metastatic osteosarcoma was given high dose methotrexate treatment, and favipiravir was started on the third day of the treatment with suspicion of SARS-CoV2 infection. Grade 3 hepatotoxicity developed after favipiravir.Management & outcome: The acute viral hepatitis panel and autoimmune liver disease panel were negative. The ultrasound of the abdomen was unremarkable for any hepatobiliary pathology. The all viral and hepatobiliary possible etiological factors were ruled out. The patient's liver enzymes increased just after (12 hours later) the initiation of favipiravir, and we diagnosed toxic hepatitis caused by favipiravir-methotrexate interaction. Therefore, methylprednisolone 1 mg/kg dose was started for a presumed diagnosis of toxic hepatitis. Hepatotoxicity completely regressed after favipiravir was discontinued. DISCUSSION: Favipiravir may inhibit methotrexate elimination by inhibiting aldehyde oxidase and its sequential use may cause hepatotoxicity in this case. The clinicians should keep in mind possible drug interactions while using new antiviral agents against SARS-CoV2 like favipiravir.
Subject(s)
Bone Neoplasms , COVID-19 , Chemical and Drug Induced Liver Injury , Osteosarcoma , Pharmaceutical Preparations , Amides , Antiviral Agents/therapeutic use , Bone Neoplasms/drug therapy , Chemical and Drug Induced Liver Injury/drug therapy , Chemical and Drug Induced Liver Injury/etiology , Humans , Methotrexate/adverse effects , Osteosarcoma/drug therapy , Pyrazines , RNA, Viral , SARS-CoV-2Subject(s)
COVID-19/diagnosis , Stevens-Johnson Syndrome/diagnosis , Adrenal Cortex Hormones/therapeutic use , Androstadienes/therapeutic use , Aromatase Inhibitors/therapeutic use , Body Surface Area , Bone Neoplasms/complications , Bone Neoplasms/drug therapy , Bone Neoplasms/secondary , Brain Neoplasms/complications , Brain Neoplasms/drug therapy , Brain Neoplasms/secondary , Breast Neoplasms/complications , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , COVID-19/complications , Dexamethasone/therapeutic use , Emollients/therapeutic use , Female , Hospitalization , Humans , Liver Neoplasms/complications , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Middle Aged , Palliative Care , SARS-CoV-2 , Stevens-Johnson Syndrome/drug therapy , Stevens-Johnson Syndrome/etiology , Stevens-Johnson Syndrome/pathologyABSTRACT
A 78-year-old man had a medical history of hypertension, atrial fibrillation, chronic kidney disease, and metastatic castration-resistant prostate cancer (CRPC). He had progressed to first-line therapy for CRPC with abiraterone plus androgen-deprivation therapy (ADT) and as second-line therapy he was being treated with docetaxel, with biochemical progression in his last prostate specific antigen measurement. He was admitted to the hospital on April 2020, in the middle of the coronavirus disease 2019 (COVID-19) pandemic, because of painful bone lesions and deterioration of renal function.