Tamponada serca w przebiegu raka piersi jako objaw nawrotu choroby

Cardiac tamponade is life-threatening state caused by fluid accumulation in the pericardial sac and consequently by increase of intrapericardial pressure. In neoplastic disease pericardiac involvement which manifests clinical symptoms as cardiac tamponade occurred uncommon and  can be cancer first symptom or develop in it’s terminal period. The most common neoplastic cause of the pericardial effusion are metastatic tumors, especially from lung and breast cancer. In this case report cardiac tamponade was the first symptom of breast cancer recurrence and then occurred again during systemic treatment as the symptom of disease progression.Tamponada serca jest stanem zagrożenia życia wywołanym nagromadzeniem się płynu w worku osierdziowym i w konsekwencji wzrostem ciśnienia śródosierdziowego. W chorobie nowotworowej zajęcie osierdzia manifestujące się objawami klinicznymi w postaci tamponady występuje rzadko i może być pierwszym objawem choroby lub rozwinąć się w jej okresie terminalnym. Najczęstszą przyczyną wysięku nowotworowego są guzy przerzutowe, zwłaszcza z raka płuca i piersi. Prezentowany przypadek dotyczy chorej, u której tamponada serca była pierwszym objawem nawrotu raka piersi a następnie ponownie wystąpiła podczas leczenia systemowego jako objaw progresji.

Chemotherapy in disseminated thymoma - case report, own experience

Grasiczaki należą do nowotworów, które powstają z tkanki nabłonkowej grasicy. Zabieg chirurgiczny odgrywa główną rolę w leczeniu grasiczaków, ale chemioterapia może znacząco wpływać na polepszenie prognoz dla tej grupy pacjentów. Skuteczna chemioterapia może mieć charakter leczenia neoadjuwantowego przed zabiegiem operacyjnym, uzupełniającego po zabiegu, stanowić element leczenia skojarzonego z radioterapią lub być stosowana w przebiegu rozsiewu choroby. Celem pracy jest przedstawienie przypadku 66-letniego chorego, u którego rozpoznano zaawansowanego grasiczaka i zastosowano z dobrym efektem leczenie systemowe dwóch linii. Pneumonol. Alergol. Pol. 2011; 79, 3: 222-226Thymomas are thymic epithelial neoplasms. Surgery plays a major role in thymoma treatment but chemotherapy can significantly improve prognoses for this group of patients. Neoadjuvant chemotherapy (before surgery), adjuvant chemotherapy (after surgery), chemotherapy combined with radiotherapy and palliative chemotherapy in dissemination stage could be required in effective therapy. The aim of this paper is description of the effective systemic second line treatment in the case of 66 years old patient with advanced thymoma. Pneumonol. Alergol. Pol. 2011; 79, 3: 222-22

The use of imatinib in the treatment of inoperable dermatofibrosarcoma protuberans in the area of the shoulder joint

Introduction. Dermatofibrosarcoma protuberans (DFSP) is a rare sarcoma of the skin and subcutaneous tissue. The most common clinical problem is its local recurrence. The therapeutic procedure of choice is radical surgery. In the case of inoperable disease, targeted therapy with imatinib, a tyrosine kinase inhibitor, may cause significant reduction of tumor volume and even enable radical surgery. Objective. We present the effectiveness of imatinib for the treatment of unresectable DFSP localized in the area of the shoulder joint of a 62-year-old woman. Case report. The patient met the criteria for inclusion in treatment with imatinib. After 3 cycles of treatment, partial regression of the lesions (above 50%) was observed. Therapy was complicated by hepatological side effects during the sixth cycle. Treatment was continued with a reduced dose when transaminase levels normalized. In a physical examination and imaging studies, further regression was observed. The patient has regained considerable mobility of the shoulder joint. A decision to continue the treatment has been made. Conclusions. The use of imatinib allowed a clinical benefit to be gained in the form of significant regression of lesions. A very good treatment response and significant improvement in quality of life of the patient were achieved. The patient has been treated with imatinib for 30 months

Treatment related toxicity in BRCA1-associated epithelial ovarian cancer – is DNA repairing impairment associated with more adverse events?

Aim of the study: The presence of BRCA germline mutations in patients with ovarian cancer has been shown to have predictive and prognostic significance, including increased platinum-sensitivity. The aim of the study was to evaluate if patients with BRCA1-associated ovarian cancer have more treatment related adverse events and, if so, does it have impact on chemotherapy outcomes. Material and methods : We conducted a retrospective analysis of medical records of 172 patients with newly diagnosed epithelial ovarian cancer, treated in Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch between 2007 and 2013. Ninety-six of these patients have known BRCA mutation status – 21 patients were BRCA1(+) and 75 BRCA1(–). Analysed treatment related adverse events (AE’s) were: haematological toxicity, nausea/vomiting, neuropathy and mucositis. Results : Grade 3–4 haematological AE’s were significantly more common among BRCA1(+) patients (OR = 3.86; 95% CI: 1.14–13.23; p = 0.02). There was no association between BRCA1 mutation status and neuropathy (p = 0.73) or nausea/vomiting (p = 0.91). Occurrence of above mentioned AE’s has no significant association with PFS (p = 0.75, 0.64, 0.97 respectively) and OS (p = 0.64, 0.69, 0.73 respectively). Conclusions : Among patients with BRCA1-associated epithelial ovarian cancer we observed significantly more grade 3–4 haematological complications after chemotherapy. However, occurrence of AE’s did not correlate with better outcomes in this subgroup

Interstitial pneumonia during treatment with rituximab

Rituximab (RTX) is a chimeric anti-CD20 antibody. It plays an important role in the treatment of B-cell lymphomas and diseases of autoaggression. RTX-induced lung disease is a rare entity, which should be considered in those patients treated with RTX who present with pulmonary disorders with no clear evidence of infection. A 37-year-old woman suffering from CD20-positive DLBCL (diffuse large B-cell lymphoma) received two cycles of the R-CHOP (RTX, cyclophosphamide, doxorubicin, vincristine and prednisone) regimen. After the second cycle of immunochemotherapy, symptoms of interstitial pneumonia occurred. Having excluded all the other causes, it was diagnosed as a complication associated with the administration of RTX

Chemotherapy in the Management of Disseminated Thymoma: A Case Report and the Authors’ Own Experience

Thymomas are tumours originating from the epithelial tissue of the thymus. While surgery is the mainstay of therapy in thymoma, chemotherapy may significantly improve the prognosis. Effective chemotherapy may be administered in the neoadjuvant setting (prior to surgery), in the adjuvant setting (following surgery), may be combined with radiotherapy or be used for palliation in disseminated disease. We report a case of a 66-year-old male with advanced thymoma who received second-line treatment with a good outcome