Aggressive lymphoma presenting as dysphagia: A rare cause of dysphagia.

Diffuse large B-cell lymphoma (DLBCL) can involve the esophagus from local spread, distant metastasis and very rarely can also be the primary site. Once DLBCL is diagnosed, caution should be exercised in further evaluation for local treatments of sites like adnexal masses as was seen in this case; sometimes it is DLBCL at atypical sites.

Disease-specific survival for patients with multiple myeloma: significant improvements over time in all age groups.

This study analyzed the survival of patients with multiple myeloma. Surveillance, Epidemiology, and End Results (SEER) and Centers for Disease Control and Prevention (CDC) databases were queried to calculate myeloma cause-specific survival curves by the Kaplan and Meier product-limit method. The Cox proportional hazards model was used to assess univariate and multivariate predictors of myeloma cause-specific survival. The outcome of interest was death due to myeloma. Results from a Cox proportional hazards model restricted to age and time period at diagnosis demonstrated that the magnitude of improvement in survival by time period varied by age at diagnosis. Among patients under 60 years at diagnosis, hazard ratios for myeloma cause-specific death decreased by more 50% from the first interval of observation to the last. Hazard ratios decreased during the study period by 39% among patients 60-69 years of age and by 27% among patients who were 70 years of age and older. Survival is improving in patients with myeloma of all ages.

The role of antiresorptive therapies in improving patient care in early and metastatic breast cancer.

Breast cancer is the second most common cancer among American women and has a high rate of metastasis to bone. Patients regularly undergo adjuvant therapy (chemotherapy or hormonal therapy) following surgical resection of the tumor. In addition to potential direct effects on bone cells, both chemotherapy and hormonal therapy induce ovarian dysfunction and dramatically decrease estrogen levels in both pre- and postmenopausal women. This leads to decreased bone mineral density and increased fracture risk. Antiresorptive therapies (e.g, zoledronic acid and denosumab) have demonstrated efficacy in preventing cancer therapy-induced bone loss in patients with breast cancer and are approved for the prevention of skeletal-related events in patients with bone metastases from breast cancer. This review will focus on the evolving role of these antiresorptive therapies in the care of women with early or metastatic breast cancer.

Thrombosis and malignancy: a case-based review.

The association between venous thromboembolism (VTE) and malignancy is well established. Recent interest has focused on standards of care for prophylaxis, diagnosis, and treatment of malignancy-associated thrombosis. Anticoagulant management in cancer patients has unique complexities such as prolonged hospitalization, extensive surgeries, extended periods of inactivity, indwelling central venous catheters (CVC), thrombocytopenia, and pro-thrombotic medications. Here we will explore current recommendations for various specific clinical scenarios for cancer-associated thromboses. We will make evidence-based recommendations wherever possible; however, several of the scenarios here were included because pertinent high-quality evidence does not exist.