ABSTRACT
Drop metastases from glioblastoma multiforme (GBM) to the spinal cord are extremely rare in clinical practice. We report herewith multiple drop metastases to the cervical and thoracic spinal cord presenting as paraplegia in a patient treated initially with tumor resection followed by chemoradiation and later with temozolomide-.based adjuvant chemotherapy.
Subject(s)
Antineoplastic Agents, Alkylating/adverse effects , Dacarbazine/analogs & derivatives , Glioblastoma/pathology , Infratentorial Neoplasms/pathology , Spinal Cord Neoplasms/secondary , Dacarbazine/adverse effects , Glioblastoma/drug therapy , Humans , Infratentorial Neoplasms/drug therapy , Male , Middle Aged , Prognosis , Spinal Cord Neoplasms/chemically induced , TemozolomideABSTRACT
Radiation-induced hypopigmentation consistent vitiligo has been reported in a few case reports. We report herewith a case of vitiligo at the site of radiation delivery after a lag of several months in a patient with preexisting hypothyroidism without a previous or family history of vitiligo, and review the cases reported in the literature collectively.
ABSTRACT
The reports of a unique mutation in the Janus kinase-2 gene (JAK2) in polycythemia vera by several independent groups in 2005 quickly spurred the development of the Janus kinase inhibitors. In one of the great victories of translational research in recent times, the first smallmolecule Janus kinase inhibitor ruxolitinib entered a phase I trial in 2007. With the approval of ruxolitinib by the US Federal Drug Administration in November 2011 for high-risk and intermediate-2 risk myelofibrosis, a change in paradigm has occurred in the management of a subset of myeloproliferative neoplasms (MPN): primary myelofibrosis, post-polycythemia vera myelofibrosis, and post-essential thrombocythemia myelofibrosis. Whereas the current evidence for ruxolitinib only covers high-risk and intermediate-2 risk myelofibrosis, inhibitors with greater potency are likely to offer better disease control and survival advantage in patients belonging to these categories, and possibly to the low-risk and intermediate-1 risk categories of MPN as well. But use of the Janus kinase inhibitors also probably has certain disadvantages, such as toxicity, resistance, withdrawal phenomenon, non-reversal of histology, and an implausible goal of disease clone eradication, some of which could offset the gains. In spite of this, Janus kinase inhibitors are here to stay, and for use in more than just myeloproliferative neoplasms.
ABSTRACT
Metastasis to the breast from an extra-mammary primary is a rare phenomenon; metastasis from gastric carcinoma to the breast is extremely so. We report a case who initially presented as mucin-secreting and signet-ring cell tumor of the ovary, and after an interval of 8 months with breast and chest wall metastatic nodules. The covert gastric primary eluded the oncologists at both presentations.