Preventative and Personalized Approach to the Treatment of Malignant Melanoma: A Case Report.

This case report is focused on malignant melanoma, a common potentially lethal skin cancer, and its unique management. In our pa­tient’s case, the primary cutaneous melanoma occurred 28 years prior to presenting with axillary lymphadenopathy, which was later determined to be a metastatic focus of melanoma; subsequent nodules were found in his spleen. After completion of his treatment and routine screening, additional nodules were discovered in his chest. Primary and secondary prevention were important in the man­agement of this patient, as well as personalization of his treatment. Cette étude de cas porte sur le mélanome malin, un cancer de la peau potentiellement mortel avec une gestion unique. Dans le cas de notre patient, le mélanome s’est présenté 28 ans avant la présentation d’une lymphadénopathie axillaire, ce qui a été démontré par la suite comme une zone étant métastatique du mélanome. Des nodules ont été découverts dans sa rate. Suite à la fin des traitements et des suivis de routine, des nodules additionnels ont été découverts dans sa poitrine. Des préventions primaires et secondaires sont importantes pour la gestion de ce patient ainsi qu’un traitement personnalisé

Enumerating pelvic recurrence following radical cystectomy for bladder cancer: A canadian multi-institutional study

Introduction: We aimed to enumerate the rate of pelvic recurrence following radical cystectomy at university-affiliated hospitals in Canada. Methods: Canadian, university-affiliated hospitals were invited to participate. They were asked to identify the first 10 consecutive patients undergoing radical cystectomy starting January 1, 2005, who had urothelial carcinoma stages pT3/T4 N0-2 M0. The first 10 consecutive cases starting January 1, 2005 who met these criteria were the patients submitted by that institution with information regarding tumour stage, age, number of nodes removed, and last known clinical status in regard to recurrence and patterns of failure. Results: Of the 111 patients, 80% had pT3 and 20% pT4 disease, with 62% being node-negative, 14% pN1, and 27% pN2; 57% had 10 or more nodes removed. Cumulative incidence of pelvic relapse was 40% among the entire group Conclusions: This review demonstrates a high rate of pelvic tumour recurrence following radical cystectomy for pT3/T4 urothelial cancer

Primary Burkitt lymphoma of the supraglottic larynx: a case report and review of the literature

Abstract Background Burkitt lymphoma is a high-grade B cell lymphoma which accounts for less than 1% of all adult cases of non-Hodgkin lymphoma. Rare instances of Burkitt lymphoma developing secondary to prior irradiation have been described in the literature. Case presentation We report a case of a 90-year-old white woman with a recent history of irradiation for Hodgkin lymphoma, who presented with primary Burkitt lymphoma of the supraglottic larynx. She underwent emergency awake tracheostomy with biopsy. A histopathological examination confirmed non-Hodgkin, B cell lymphoma of Burkitt type. Given her age and poor functional status, she underwent treatment with palliative radiotherapy. Conclusions A literature review was performed to clarify the clinical characteristics of radiation-induced Burkitt lymphoma in the head and neck, as well as its diagnosis and management. The present case represents the second case of radiation-induced Burkitt lymphoma in the head and neck in the reported literature, and the first in the supraglottic larynx. It highlights the need to maintain a broad differential in the assessment of malignancies of the larynx, particularly in patients with a prior history of radiation treatment

Adjuvant radiotherapy for pathological high-risk muscle invasive bladder cancer: time to reconsider?

Radical cystectomy with extended pelvic lymph-node dissection, associated with neo-adjuvant chemotherapy, remains the standard of care for advanced, non-metastatic muscle-invasive bladder cancer (MIBC). Loco-regional control is a key factor in the outcome of patients since it is related to overall survival (OS), disease-free survival (DFS) and cause-specific survival. The risk of loco-regional recurrence (LRR) is correlated to pathological factors as well as the extent of the lymphadenectomy. In addition, neither pre- nor post-operative chemotherapy have shown a clear impact on LRR-free survival. Several recent publications have led to the development of a nomogram predicting the risk of LRR, in order to identify patients most likely to benefit from adjuvant radiotherapy. Given the high risk of LRR for selected patients and improvements in radiation techniques that can reduce toxicity, there is a growing interest in adjuvant radiotherapy; international cooperative groups have come together to provide the rationale in favor of adjuvant radiotherapy. Clinical trials in order to reduce the risk of pelvic relapse are opened based on this optimizing patient selection. The aim of this critical literature review is to provide an overview of the rationale supporting the studies of adjuvant radiation for patients with pathologic high-risk MIBC