Case report: Axillary lymph node metastases from primary ovarian cancer: a report of two cases and literature review

Ovarian cancer is usually confined intraperitoneally. Distant metastases at presentation is unusual. Its spread via lymphatics is uncommon, and metastasis to axillary lymph nodes is very rare. We report two cases with presentation of axillary lymphadenopathy without breast involvement. Computed tomography scan identified the ovarian masses. Both had elevated Serum Ca 125. The first case had a Grade 2 ovarian endometrioid carcinoma. The second case had a high-grade serous ovarian carcinoma. These cases illustrate the rarity of axillary lymphadenopathy from ovarian cancer. It is important to identify the primary ovarian carcinoma in order to offer appropriate management. Despite surgery and chemotherapy, both succumbed within 3 years from diagnosis

Multi-disciplinary approach for managing plasmacytoma: a case report

Solitary plasmacytoma (SP) is a tumor with evidence of clonal plasma cells and no other features of multiple myeloma (MM). We report a case of SP which showed multiple recurrences of SP and then evolution into overt MM. A 56-year-old man presented with the 5-month-history of right nasal obstruction and intermittent epistaxis. He had SP (extraosseous) of right nasopharynx (3.5 × 2 × 2.5 cm), with no paraproteinaemia. He received radiotherapy (56 Gy), achieving complete remission. Ten years later, he had recurrence of SP (osseous) in left tibia, presenting with pathological fracture. He received radiotherapy (50 Gy), achieving partial response. Three years later, he had recurrence of SP (osseous) in right tibia, presenting with right leg pain. He received radiotherapy (45 Gy). While receiving treatment, he had progressive swelling in the area around right eye, double vision and headache. Imaging scans showed multiple plasmacytomas. There were presence of monoclonal paraprotein, hypercalcemia and lytic bone lesions. He was diagnosed as MM (at the age of 70 years) and treated with Bortezomib-based therapy. Currently, after one cycle of treatment, clinical improvement is achieved. The importance of multi-disciplinary team approach for managing patients with plasmacytoma is highlighted in order to achieve the holistic approach of management

Gastrocnemius acrometastasis from muscle-invasive urothelial bladder carcinoma: A case report

Urinary bladder carcinoma is a common malignancy worldwide. The metastatic disease to distant organs including lung, liver, and bone is well established. However, metastasis to below-knee-level; also known as acrometastasis is a rare occurrence and occurs approximately 0.1% of all bone metastases. It is standard of care to obtain a contrast enhanced computed tomography scan of the chest, abdomen, and pelvis for pretreatment planning, primary staging, and post treatment disease surveillance. This makes the occurrence of acrometastasis harder to detect and may only manifest clinically in advance disease. We report a case of 55 years old gentleman treated as muscle-invasive bladder urothelial carcinoma, presented with chronic left knee pain, and imaging demonstrating tumor in the left knee region. Histopathologic study shows features of metastatic disease from urinary bladder carcinoma to the left gastrocnemius muscle. The attending physician should raise the suspicion of metastatic disease if the patient with known malignancy presented with new soft tissue lesion elsewhere in the body