Reviews & Analysis

A choroidal metastasis usually presents as blurred vision or decreased visual acuity and is usually an indicator of poor outcome. The authors describe the case of a 57-year-old woman with a history of breast cancer that presented with distorted vision and decreased visual acuity in her left eye. The authors discuss the use of radiation and hormonal therapy to manage this case of choroidal metastasis from breast carcinoma.

The authors present the case of a 57-year-old male who was diagnosed with grade IV glioblastoma multiforme and enrolled in a clinical trial of adoptive cellular immunotherapy. The authors used PET imaging technology to image the T cells non-invasively and report the first case using a non-invasive imaging reporter gene/probe technology.

Anal mucosal melanoma is a disorder with limited treatment options and is associated with a poor prognosis. The authors describe the case of a 79-year-old man who was diagnosed with stage IV anal mucosal melanoma expressing the KIT Val560Asp mutation, and was treated with surgery, radiotherapy, and a combination of sorafenib and temozolomide therapy. The authors discuss the potential therapeutic use of sorafenib in anal mucosal melanoma patients with specific mutations such as the KIT Val560Asp mutation.

The treatment options for patients with chemoresistant diffuse large B-cell lymphoma are limited. Fenske et al. describe the case of a 41-year-old man with chemorefractory lymphoma, who was treated with yttrium-90 microsphere embolization of his hepatic tumors. The patient's lymphoma progressed and he died, but there was no evidence of recurrence in the liver. The authors discuss yttrium-90 microsphere embolization for patients who have chemoresistant lymphoma with involvement of the liver.

Testicular germ-cell cancer is the most common solid malignancy affecting males in puberty and adulthood. Ponti et al. report the case of a 45-year-old man who was initially misdiagnosed with stage I seminoma, developed brain metastases and finally died. Pathology review showed large B-cell lymphoma in the primary tumor. The authors underline the need for accurate histology review in testicular tumors with unusual clinical features.

The prognosis for patients with advanced melanoma and CNS metastases is poor. Hodi et al. report the case of a 63-year-old female who was diagnosed with metastatic melanoma from an unknown primary tumor. The authors discuss the use of the human monoclonal antibody against CTLA-4, ipilimumab, in patients with metastatic melanoma.

The tumor suppressor syndrome neurofibromatosis type 2 (NF2) is transmitted in an autosomal dominant fashion. Plotkin et al. report the case of a 48-year-old man who was diagnosed with progressive NF2-related vestibular schwannomas and received erlotinib therapy, which resulted in improved audiologic and radiographic responses. The authors discuss the potential effectiveness of targeted therapies for progressive vestibular schwannoma in NF2 patients.

Patients treated with irradiation for Hodgkin's lymphoma are at increased risk of breast cancer. Alm El-Din et al. report the case of a 57-year-old woman who was diagnosed with breast cancer 15 years after receiving mantle irradiation for Hodgkin's lymphoma and was managed with lumpectomy and partial breast irradiation. The authors suggest partial breast irradiation as a feasible approach for women who develop breast cancer after Hodgkin's lymphoma and decline mastectomy.

Proteus syndrome is a rare hamartoma syndrome that is characterized by the presence of germlinePTEN mutations and causes benign and malignant tumors. Marsh et al. report the case of a 16-month boy who was diagnosed with Proteus syndrome, and was managed with oral rapamycin. On the basis of this patient's promising outcome, the authors discuss the rationale for rapamycin therapy for patients with disorders within the PTENhamartoma tumor syndrome spectrum.

Allogeneic hematopoietic stem-cell transplantation is the only curative treatment for the majority of patients with high-risk or advanced hematologic malignancies. Schöttker et al. describe the case of a male patient with acute lymphoblastic leukemia who received cord-blood, third-party CD34⁺stem-cell, and T-cell transplantation after experiencing primary graft failure. The authors discuss the therapeutic potential of this combined non-HLA restricted transplantation for patients with hematologic disorders.

Methotrexate-associated lymphoproliferative disorders are rare conditions mostly observed in patients receiving immunosuppression therapy. Tran and coauthors report the first documented case of methotrexate-associated mantle-cell lymphoma in a 75-year-old patient with myasthenia gravis. After cessation of methotrexate, the patient was treated with anthracycline-based combination chemoimmunotherapy and maintenance rituximab therapy and achieved complete remission. The authors discuss the management options for patients with methotrexate-associated mantle-cell lymphoma.

Cardiac angiosarcomas are characterized by a difficult clinical diagnosis and poor prognosis. Pigott et al. report the case of a 37-year-old man diagnosed with primary cardiac angiosarcoma with systemic metastases who was managed with neoadjuvant and adjuvant chemotherapy with doxorubicin, and complete resection of the tumor. The authors discuss the combination of treatments undertaken, and suggest a multidisciplinary approach to improve outcome in patients with cardiac angiosarcoma.

Placental-site trophoblastic tumors (PSTTs) are often resistant to chemotherapy and have a high incidence of lung metastasis. Cole et al. report the case of a 52-year-old woman who was diagnosed with metastatic chemoresistant PSTT. The patient was managed with abdominal hysterectomy, salpingo-oophrectomy, radiotherapy, chemotherapy, and thoracotomy with wedge resection. The authors discuss the treatment options for patients with PSTTs, especially for those with persistent metastatic disease.

Urachal adenocarcinomas are rare primary adenocarcinomas of the bladder for which there is no current chemotherapy regimen. Mohile and co-authors report the case of a 67-year-old woman who was diagnosed with metastatic urachal adenocarcinoma and achieved complete remission of the disease after irinotecan, 5-fluorouracil and leucovorin therapy. The authors discuss the current management options for patients with urachal adenocarcinomas and emphasize the need to evaluate the role of newly discovered agents in the treatment of this disease.