ABSTRACT
Crizotinib has been approved for the treatment of advanced ALK-positive non-small cell lung cancer. Its use is associated with the development of complex renal cysts. However, there is limited literature regarding imaging features of renal cystic disease during crizotinib therapy and its complications or progression. Here, we describe a case of a patient with ALK-positive advanced non-small cell lung cancer who developed complex renal cyst during crizotinib treatment. The renal cyst is complicated by infection and abscess formation. Subsequent renal biopsy, antibiotics treatment, and open drainage of loculated renal abscess showed no malignant cells and contributed to the diagnosis. The imaging features should be recognized as renal cystic disease of crizotinib treatment and not to be mistaken as new metastasis and disease progression.
ABSTRACT
OBJECTIVE: Spinal abscess is a rare but potentially devastating condition. We present a case series, looking into its presentation, risk factors, management and outcome. METHODS: Five patients over a 10 year period were identified, with a discharge diagnosis code of 'spinal abscess, 324.1' from the hospital computer database. RESULTS: Four out of five patients presented atypically. Prognosis corresponded to early diagnosis and surgical decompression. Risk factors included intravenous drug abuse, a compromised immune system and infection in another organ system. Magnetic resonance imaging was an important diagnostic tool for all. CONCLUSION: The early diagnosis and immediate surgical treatment of spinal abscesses remain cornerstones in improving the outcomes of the disease. From our series, risk factor assessment appear to be more useful than the classical triad of fever, spine pain and neurological deficits to screen ED patients with spine pain for spinal abscess.
