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Oncology

Case studies

ALS in a patient with CLL and drug-related SLR

A man with a skin rash and left leg weakness was diagnosed with sarcoid-like reaction due to treatment for chronic lymphocytic leukemia, and ultimately also amyotrophic lateral sclerosis when the motor symptoms progressed.

Asciminib discontinuation feasible in CML

There are minimal data concerning treatment-free remission after discontinuation of the novel TKI asciminib in people with chronic myeloid leukemia. These two cases provide proof of principle that sustained TFR is possible in selected patients.

Primary vitreoretinal lymphoma mimics fungal endophthalmitis

PVRL is a life-threatening neoplasm. It can be mistaken for non-infectious uveitis, as it often presents with vitritis that responds to corticosteroids, but this case shows that it can also mimic infectious uveitis.

Late-onset ICI-related pneumonitis

Pneumonitis related to ICI therapy typically occurs within the first few months of treatment, but this lung cancer patient experienced the adverse event 2.5 months after discontinuing pembrolizumab, underscoring the need for long-term vigilance.

An isolated metastatic papillary thyroid carcinoma in the orbit

Exophthalmos and an acute decline in visual acuity developed several years after treatment for papillary thyroid carcinoma. An isolated mass in the orbital cavity was excised and vision improved with no need for adjuvant therapy.

An unusual co-occurrence of thyroid tumors

A solitary fibrous tumor of the thyroid was unexpectedly found during the workup of bilateral papillary thyroid carcinoma in a woman with no prior medical history who presented with a year-long indwelling cervical swelling.

Four cases of ICI-related fulminant myocarditis

Fatal outcomes in three cases, despite aggressive treatment, emphasize the poor prognosis of fulminant myocarditis related to immune checkpoint inhibitor therapy.

Rare complication in a patient with seminoma

A patient treated with carboplatin for stage I seminoma developed hematuria and acute kidney injury. It is crucial to recognize this rare but serious complication and start treatment promptly to prevent further kidney damage.

Cushing disease or ectopic adrenocorticotrophic hormone syndrome?

A girl with typical signs and symptoms of hypercortisolemia experienced adrenal insufficiency while on oral ketoconazole. Ectopic ACTH syndrome due to a thymic neuroendocrine tumor was diagnosed.

Total resection via right mini-thoracotomy of a left atrial myxoma in a child

Carney complex is a rare syndrome characterized by skin pigmentation, endocrine disorders, and myxomas. This case presents a 13 year old girl diagnosed with Carney complex who underwent a successful right lateral mini-thoracotomy.

A rare case of splenic marginal zone lymphoma transformation

Splenic marginal zone lymphoma is an indolent tumor, which in this case transformed into a highly aggressive DLBCL. The authors speculate that an MYD88 mutation may have played a role in the histologic transformation.

Co-existing parathyroid adenoma, thyroid carcinoma, and tuberculosis of the thyroid

A rare case of parathyroid adenoma, thyroid carcinoma, and thyroid tuberculosis in a woman with a history of hypothyroidism who developed a swelling on her neck and bone pain.

CUP presenting with heart failure

Heart failure as an unusual first manifestation of carcinoma of unknown primary, highlighting that common clinical symptoms can reveal uncommon neoplastic etiologies.

Atypical presentation of PJP

Typical symptoms of Pneumocystis jirovecii pneumonia include dyspnea, cough, and low-grade fever. But this patient, an allogeneic stem cell transplant recipient, presented with hypercalcemia and kidney injury.

Stroke as initial manifestation of CML progression

A patient with chronic myeloid leukemia presented with the signs and symptoms of acute ischemic stroke and was found on further evaluation to have progressed to the promyelocytic blast phase.

Tracheopericardial fistula masquerading as acute MI

Tracheopericardial fistula is often misdiagnosed due to its rarity and nonspecific presentation. In this patient with recurrent lung cancer, it was initially mistaken for an acute myocardial infarction.

Uncommon presentation of DLBCL

Diagnosis of diffuse large B-cell lymphoma remains a challenge due to the variety of clinical presentations. In this case, the presenting features were lesions in the upper jaw as well as chronic cough and dyspnea.

Combined treatment for PML

Progressive multifocal leukoencephalopathy is an often fatal CNS disease caused by JC virus infection. In this case, low-dose, long-term immunoglobulin plus mirtazapine resulted in a controlled inflammatory reaction.

A giant, invasive, wall-penetrating cardiac lipoma

  • Open Access
  • Lipoma
  • Case Study

This case presents the successful surgical resolution of a unique cardiac lipoma. The lipoma was shaped like a dumbbell, and extended both internally and externally across endocardial and epicardial layers of the right atrium. 

CLL presenting with central airway obstruction

Central airway obstruction is a very rare complication in patients with chronic lymphocytic leukemia, but in this case, chest tightness and dyspnea due to obstruction were the presenting features.

CAR T-cell therapy for CML in blast phase

A 16-year-old with repeatedly relapsing chronic myeloid leukemia in blast phase achieved a durable response to CAR T-cell therapy when multiple previous treatments had led only to short-term molecular remissions.

Exceptionally rare manifestation of papillary thyroid cancer

Spontaneous hepatic hemorrhage is a rare condition that is mostly seen in patients with hepatocellular carcinoma or hepatic adenomas. But in this case it was caused by metastasized papillary thyroid cancer.

Worsening heart failure in a survivor of cancer as a young adult

Severe cardiomyopathy presenting 20 years after anthracycline treatment for non-Hodgkin’s lymphoma during early adulthood. The patient's worsening heart failure was successfully managed with multidrug treatment with add-on vericiguat and ivabradine based on quadruple therapy. 

Unusual presentation of ALL

A child with acute lymphoblastic leukemia presented with nephrogenic diabetes insipidus as the initial symptom. ALL should be considered in the differential diagnosis of unexplained renal injury, even if blood investigations are normal.

ICI-induced encephalitis in a patient with HCC

Only the third reported case of encephalitis in a patient receiving atezolizumab plus bevacizumab for advanced hepatocellular carcinoma. The neurological symptoms quickly improved once steroid pulse therapy was started.

Mediastinal mass of twice an infant’s bodyweight

Giant anterior mediastinal masses pose unique challenges for resection, such as cardiovascular collapse on induction of anesthesia and injury to surrounding structures that may be compressed or displaced.

Concurrent pulmonary cryptococcosis and lung cancer

This case serves as a prompt to consider the possibility of cryptococcosis, even when lung cancer has already been diagnosed, when lung radiology shows multiple nodules.

Uncommon type of malignant melanoma

The amelanotic variant of conjunctival malignant melanoma is extremely rare and can be difficult to diagnose. Clinicians must be vigilant when changes in the conjunctiva and eyelids are noticed.

Ablation of thyroid cancer: a double-edged sword?

Thyroid ablation technology has developed rapidly in the past 20 years, but these two cases highlight how incomplete ablation of thyroid nodules hinders its use as a treatment for thyroid cancer.

Insufficient dosing of TKIs in CML

In four patients with chronic myeloid leukemia and a history of bariatric surgery, TKI concentrations were found to be subtherapeutic, and all needed TKI switches and/or dose modifications to achieve a response.

Ewing’s sarcoma: preserved walking function without postoperative reconstruction

Successful management of a left iliac Ewing’s sarcoma with multiple metastases in a 14-year-old boy, with a focus on functional preservation and infection risk reduction.

Cardiac angiosarcoma in a 17-year-old

Confirmed primary cardiac angiosarcoma in a healthy adolescent was seen to spontaneously regress after initial percutaneous biopsy, with subsequent increase in size of the mass 4 months later. 

Novel CSF biomarkers for PCNSL

Diagnosis of primary diffuse large B-cell lymphoma of the CNS is challenging and often delayed. In these three cases with varied clinical presentations and radiological findings, diagnosis was suggested by novel CSF biomarkers.

Uterine choriocarcinoma in a child

This first report of non-gestational uterine choriocarcinoma in a 4-year-old girl stresses the need to consider it as one of the differential diagnoses for intra abdominal tumors in children.

Excellent response to immunotherapy in rare pancreatic cancer

A patient with pancreatic acinar cell carcinoma responded well to treatment with pembrolizumab and was able to undergo surgery. He remains disease-free 6 months after surgery.

Adrenal insufficiency caused by immunotherapy

Three patients receiving tislelizumab immunotherapy for NSCLC developed adrenal insufficiency, highlighting the need for awareness of pituitary–adrenal axis dysfunction as an immune-related adverse event.

Hodgkin lymphoma masquerading as ocular inflammation

A 17-year-old presented with non-necrotizing scleritis, anterior uveitis, vitritis, yellowish chorioretinal lesions, papillitis, and vasculitis. Would you consider Hodgkin lymphoma in the differential diagnosis?

A novel side effect of ICI treatment

The first report of thoracic lymphangitis as an immune-related adverse event in a patient receiving adjuvant ICI treatment for lung cancer.

Unprovoked VTE revealing lung cancer

A case emphasizing the importance of occult cancer screening in patients with unprovoked venous thromboembolism, especially those with risk factors.

Preoperative immunotherapy promising in mesothelioma

A patient with advanced pleural mesothelioma experienced dramatic tumor shrinkage after neoadjuvant checkpoint inhibitor therapy, and was able to successfully undergo surgery.

Ectopic adrenocortical adenoma characterized by hypogonadism

Functional localization tests identified a rare case of ectopic adrenocortical adenoma in a woman with ACTH-independent Cushing syndrome and primary amenorrhea due to gonadotropin deficiency.

A challenging case of CAP

A woman presenting with community-acquired pneumonia developed several serious complications, likely due to co-existence of poorly controlled diabetes and a late diagnosis of thyroid cancer.

HF from a cutaneous hemangioma

Large cutaneous hemangiomas can be hemodynamically significant, resulting in high-output heart failure and pulmonary hypertension. Embolization and resection is effective and well-tolerated.

Misdiagnosis of MMNST of the cervical spinal cord

Malignant melanotic nerve sheath tumors are rare and highly aggressive. In this case MMNST was misdiagnosed as a benign vascular malformation, then recurred 7 months after resection.

Strumal carcinoid tumor of the ovary

Salpingo-oophorectomy was performed after 15 years’ surveillance of an ovarian dermoid cyst in a female with type 2 diabetes. The removed ovary contained a mature cystic teratoma and a discrete solid nodule.

Neurological complications of CAR T-cell therapy

A 38-year-old with B-cell acute lymphocytic leukemia developed a brain abnormality, detected by CT scan on day 16 following CAR T-cell infusion. How would you assess and treat her?

Misdiagnosis of pulmonary artery sarcoma

A pulmonary arterial sarcoma was mistaken as pulmonary vasculitis due to similarities between the diagnoses. This case highlights some cardinal features of the malignancy that are not seen in vasculitis.

Neonatal meningitis: new and old lessons

A premature infant presented with extensive CNS injury from recurrent E. coli infection, requiring non-traditional methods to identify and clear the infection.

Oncolytic virus therapy promising in mucosal melanoma

Intralesional treatment with the oncolytic virus talimogene laherparepvec led to a complete local response in a patient with oral mucosal melanoma who was ineligible for other anticancer therapies.

A challenging diagnosis: melanoma or clear cell sarcoma?

A case of clear cell sarcoma of soft tissue misdiagnosed as malignant melanoma underscores the need for an integrated diagnostic approach involving clinical, histopathological, and radiological evaluations.

Blastocystis hominis infection presenting as immune thrombocytopenia

Screening for potential predisposing factors is essential in patients with ITP who have poor response to first-line treatment. This unusual case was related to parasitic infection.

Hyalinizing trabecular tumor of the thyroid

Imaging, cytologic, histologic, and molecular investigations all contributed to the diagnosis of a rare case of HTT in a woman with an incidentally discovered mass in the left lobe of her thyroid gland.

A challenging diagnosis of lung cancer

Although uncommon, lung cancer in patients with granulomatosis with polyangiitis can be difficult to diagnose due to similarities in imaging findings.

Arrhythmia secondary to abiraterone treatment

A man receiving abiraterone for prostate cancer developed severe hypokalemia, which led to polymorphic ventricular tachycardia and cardiac arrest. It is important to consider iatrogenic causes in cases of arrhythmia.

Insulinoma misidentified as schizophrenia

Intermittently scanning CGM detected hypoglycemia in a woman previously diagnosed with schizophrenia and treated with antipsychotic medication. Insulinoma was diagnosed and resected, resolving her neuropsychiatric symptoms.

Bronchopleural fistula after neoadjuvant immunochemotherapy

Bronchopleural fistula is a rare but potentially fatal complication that can occur after surgery in patients receiving neoadjuvant immunochemotherapy for stage III NSCLC.

Vocal cord paralysis caused by metastasized endometrial cancer

The first case of vocal cord paralysis due to a mediastinal metastasis developing 16 years after the patient's endometrial cancer was treated by hysterectomy, external beam radiotherapy, and chemotherapy.

Delayed diagnosis of APAP in patient with dermatomyositis

Differentiating autoimmune pulmonary alveolar proteinosis (APAP) from a flare-up of interstitial pneumonia associated with dermatomyositis is challenging. This case highlights the need for early APAP scrutiny.

Unusual presentation and delayed diagnosis of cardiac angiosarcoma

Primary cardiac angiosarcomas are very aggressive tumors that often present after metastatic spread. In this case, initial presentation with chest pain rapidly progressed to multiple solid tumors. 

A rare case of adult primary brain rhabdomyosarcoma

Primary brain rhabdomyosarcoma primarily occurs in children, but this case in a 26-year-old sheds light on managing the condition in adults.

Coronary thrombectomy for a post-op MI after brain tumor resection

How should you react to an acute MI immediately after a craniotomy for tumor resection? Management of such patients requires carefully balancing the competing risks of myocardial ischemia and postoperative bleeding. 

Management of long-lasting active Graves’ orbitopathy

Late orbital radiotherapy combined with intravenous methylprednisolone successfully treated a patient with recurrent and long-lasting unilateral reactivating Graves’ orbitopathy.

ICI-induced insulin-dependent diabetes without islet autoantibodies

Rapidly progressive insulin-dependent diabetes in the absence of islet autoantibodies developed 2 years after starting treatment with the immune checkpoint inhibitor nivolumab.

Profound hypotension induced by ICI treatment

A case of extreme hypotension that could have been prevented or mitigated with awareness of the underlying hypothyroidism related to nivolumab treatment.

Severe megaloblastic anemia related to erlotinib

  • Open Access
  • NSCLC
  • Case Study

The first case of severe megaloblastic anemia in a patient treated with erlotinib for advanced NSCLC. It highlights the need for close clinical and blood monitoring in people receiving long-term TKI therapy.

An uncommon presentation of CRC

Sciatica due to Streptococcus gallolyticus infection of the spinal epidural space led to a diagnosis of colorectal cancer in a person with none of the usual signs and symptoms.

How to diagnose mediastinal angiosarcoma

A mediastinal angiosarcoma presented mimicking signs of constrictive pericarditis, aortic dissection, and coronary artery disease. The correct diagnosis only was made measurement of hyaluronic acid concentration in the pleural fluid.

An unusual pancreatic neuroendocrine microtumor

A pancreatic neuroendocrine microtumor with a high proliferation rate but metabolic, genetic, and epigenetic features correlated with a less aggressive disease course highlights the need to better understand PanNET tumorigenesis.

Primary melanoma of the lung

A report of primary endobronchial melanoma that sheds light on the clinical presentation, histopathology, diagnostic challenges, and treatment options for this rare entity.

Skin atrophy after treatment of infantile hemangioma

Hemangiomas are the most common benign vascular tumors of infancy. Systemic propranolol successfully treated a hemangioma on a 3-month-old’s face, but left a skin defect very similar to steroid-induced skin atrophy.

Primary thyroid lymphoma: a case series

Although rare, primary thyroid lymphoma should be considered in cases of rapidly growing goiters. Timely needle biopsy can avoid unnecessary surgery.

A rare, late side effect of radiotherapy

A woman developed sudden painless ecchymosis (bruising) of her breast, which was thought to be related to the radiotherapy she received for early-stage breast cancer a year and a half earlier.

Successful management of ATO-induced acute pericarditis

A patient receiving arsenic trioxide for acute promyelocytic leukemia developed drug-induced acute pericarditis that was successfully treated with colchicine.

New ophthalmic signs of procedural stroke

Procedural stroke is a major complication of cardiac catheterization and endovascular procedures, and recognizing the signs is crucial. In this case, internuclear ophthalmoplegia caused blurred vision, diplopia, and dizziness on lateral gaze.

Rare example of a metastatic brain tumor infiltrating a meningioma

Tumor-to-tumor metastasis is the most common extracranial cancer metastasis to existing brain tumors, whereas a rare form is metastasis infiltrating tumor. In this case, a lung cancer tumor metastasized adjacent to and partially infiltrated an existing meningioma.

An aggressive presentation of secretory carcinoma

Secretory carcinoma is generally considered a slow-growing, low-grade malignant tumor, but this report describes a patient with high-grade features who presented with a soft-tissue neck mass.

Breast metastases in a male patient with nasopharyngeal carcinoma

Nasopharyngeal carcinoma is known for its high potential to metastasize, but breast metastasis is rare. The authors describe the first case of synchronous breast metastases in a male patient.

Follicular adenoma with a papillary architecture originating from an ectopic thyroid gland

Ectopic thyroid is very rarely found as a solitary tumor in the submandibular region, but it should be considered in the differential diagnosis when papillary structures are seen on histopathology.

Lung cancer in a transplanted lung

Successful surgical resection of lung cancer arising in a transplanted lung, using venovenous extracorporeal membrane oxygenation to overcome the challenge of single-lung ventilation during the procedure. 

Distinguishing sterile inflammation from graft infection

A 68-year-old man underwent ascending aortic replacement and thoracic endovascular aortic repair. Four years later, he developed aortic regurgitation and decreased ejection fraction, with no signs of infection. It is often difficult to distinguish non-infectious inflammatory response from infection in peri-graft fluid collection. 

Obinutuzumab-induced acute thrombocytopenia

A case series of three patients suggests that obinutuzumab-induced acute thrombocytopenia is a frequent, possibly non-relapsing, and unique adverse event that deserves more attention than it currently receives.

Monkeypox virus-associated meningoencephalitis

  • Open Access
  • Mpox
  • Case Study

Mpox infection can have a range of symptoms, including CNS complications such as seizures, confusion, and encephalitis. In this case, PCR of the CSF was negative for the virus, but intrathecal antibody production confirmed the diagnosis.

Carcinosarcoma of the parotid gland

Carcinosarcomas or malignant mixed tumors of the salivary gland are extremely rare. This report describes the first case of adenoid cystic carcinoma as the carcinomatous component with chondrosarcoma.

Late onset of immune checkpoint inhibitor-induced type 1 diabetes

A patient with small-cell lung cancer developed type 1 diabetes many weeks after receiving serplulimab, highlighting the need for continued monitoring of blood glucose levels and early signs and symptoms of diabetes.

Successful treatment of initially unresectable locally advanced PDAC

A patient with initially unresectable pancreatic ductal adenocarcinoma was able to have conversion surgery after chemotherapy followed by carbon-ion radiotherapy, and remains free from recurrence at 5 years.

Primary pulmonary artery sarcoma

Pulmonary artery sarcoma is a rare cancer that can be visually similar to pulmonary thromboembolism on radiographic imaging, but contrast-enhanced echocardiography helped to make an accurate diagnosis in this case.

Severe pneumonia with H5N1 and SARS-CoV-2 co-infection

A case of severe pneumonia caused by a co-infection of the H5N1 avian influenza virus and SARS-CoV-2. Precise identification of the pathogens allowed appropriate antiviral treatments to be initiated and the patient responded well.

Diagnosing primary adrenal leiomyosarcoma

Primary adrenal leiomyosarcoma is rare but should be considered a differential diagnosis for nonfunctioning adrenal tumors extending directly to the inferior vena cava. CT-guided biopsy can be useful for diagnosis and management.

Metastatic papillary thyroid cancer in the pleural space

A rare case of malignant pleural effusion as the initial presentation of metastatic papillary thyroid carcinoma in a male patient in his early 50s. 

Primary melanoma presenting in the cervical spine

When primary CNS melanoma has a spinal location, it typically manifests in the thoracic sections. This case report describes a patient with an uncommon presentation in the cervical spine. 

Pleural recurrence of a thymic mucoepidermoid carcinoma

A rare case of pleural recurrence of a high-grade thymic mucoepidermoid carcinoma 21 years after complete resection. The tumor was discovered incidentally and the patient, who remains asymptomatic, is being followed up without intervention for now.

HER2-positive mucoepidermoid carcinoma of the breast

Mucoepidermoid carcinoma of the breast is a rare type of salivary gland-like tumor that generally displays a triple-negative phenotype. This case is the first to demonstrate HER2 gene amplification.

Bilateral co-secretory lesions, coexisting Cushing syndrome and primary aldosteronism

An unusual case of co-secretory tumors in the right adrenal gland, a cortisol-secreting adenoma and an aldosterone-producing nodule in the left adrenal gland, and aldosterone-producing micronodules in both adrenal glands.

Pleomorphic liposarcoma with solitary liver metastasis

An extremely rare case of hepatic metastasis, as the first and sole site, from a pleomorphic liposarcoma in the left thigh. The patient was treated with chemotherapy and conversion surgery.

Tumor thrombus in a patient with primary adrenal diffuse large B cell lymphoma

This case highlights the need to consider whether a tumor embolism is present in the central adrenal vein, renal vein, or inferior vena cava when a diagnosis of primary adrenal lymphoma is made.

Cauda equina syndrome caused by secondary CNS lymphoma

Although cauda equina syndrome in the context of secondary CNS lymphoma is a rare occurrence, it should be considered in at-risk patients, especially those presenting with abnormal neurological findings.

Causes of chronic limping in childhood

Limping is common in children and adolescents, and is most likely due to juvenile idiopathic arthritis in patients with no previous trauma. This case series explores rare conditions that can mimic JIA.

INI1-deficient head and neck carcinoma without primary

An unusual case of an undifferentiated carcinoma of the neck lymph nodes without a primary site. The unique feature of this tumor was the INI1 deficiency.

Myeloid sarcoma of the urinary bladder

A patient with urinary bladder myeloid sarcoma as the presenting feature of secondary acute myeloid leukemia responded well to treatment with azacitidine and venetoclax.

Dedifferentiated endometrial carcinoma metastasis to axillary lymph node

An unusual case of a left axillary lymph node metastasis from a primary dedifferentiated endometrial carcinoma. The patient responded well to chemoimmunotherapy.

Tumor seeding following CT-guided transthoracic needle biopsy

The case of a lung cancer patient who developed tumor seeding 11 months after a CT-guided transthoracic biopsy highlights the need for research to better understand late complications of the procedure.

Diffuse large B‑cell lymphoma of the CNS

A 68-year-old woman was admitted to the emergency department with headache, mental confusion, and a mild hemiparesis. Explore the imaging findings, differential diagnosis, and histopathological findings that revealed the patient’s diagnosis.

Cutaneous metastasis from cervical cancer

Cutaneous metastasis is rare in cervical cancer and portends a fatal outcome. Such skin lesions warrant a thorough radiologic and pathologic workup to form a comprehensive management plan.

Cytokine release syndrome after bronchoalveolar lavage

The first report of cytokine release syndrome after bronchoalveolar lavage in a patient with organizing pneumonia from an allogeneic stem cell transplant who decompensated after routine bronchoscopy.

Lung erosion following adjuvant immunotherapy

Adjuvant pembrolizumab treatment after resection of lung metastases in a patient with renal cell carcinoma may have led to lung erosion that resulted in a pneumothorax.

Pancreatic follicular dendritic cell sarcoma

Follicular dendritic cell sarcoma of the pancreas is a rare malignant tumor, which lacks typical clinical symptoms, signs, and laboratory tests, making its diagnosis challenging.

Familial primary hyperparathyroidism with brown tumors

In this case of familial PHPT arising from parathyroid adenoma and ectopic parathyroid adenoma, brown tumors were diagnosed in a father and daughter. Genetic testing revealed the presence of CDC73 gene mutations in both individuals.

Bronchial oncocytic carcinoma

The first report of primary oncocytic carcinoma in the bronchus. No recurrence during 2 years of follow-up indicates the prognosis is as favorable as that for tumors arising in the salivary glands.

TKI treatment in NSCLC patients with poor performance status

  • Open Access
  • NSCLC
  • Case Study

Although guidelines recommend the use of tyrosine kinase inhibitors in broad groups of patients with driver mutation-positive NSCLC, this case series points to the need for further research into their efficacy in those with performance status 4.

Pulmonary accelerated rheumatoid nodules

Treatment with the JAK inhibitor baricitinib was effective in reducing the size of the pulmonary accelerated rheumatoid nodules in a patient with rheumatoid arthritis.

IgM extramedullary plasmacytoma

A case report underscoring the challenges of diagnosing IgM plasmacytoma and the importance of cytogenetics and next-generation sequencing in establishing a correct diagnosis.

​Occult extracranial malignancy after complete remission of pineal mixed germ cell tumors

Intracranial GCTs developed occult extracranial malignancy with negative tumor markers, indicating that tumor marker monitoring may need to be combined with regular follow-up abdominal imaging for early detection.

Management of respiratory failure in ICI-induced overlap syndrome

Four cases highlighting the challenges of managing acute respiratory failure in patients with immune checkpoint inhibitor-induced overlap syndrome, consisting of myasthenia gravis, myositis, and myocarditis.

Immune checkpoint inhibitor-related encephalitis

The first reported case of immune-associated encephalitis in a patient with hypopharyngeal cancer treated with the PD-1 inhibitor camrelizumab.

Gilteritinib and the risk for intracranial hemorrhage

A case series of five patients with FLT3-mutated acute myeloid leukemia who developed intracranial hemorrhage within the first month of exposure to gilteritinib.

Progressive encephalomyelitis with rigidity and myoclonus (PERM) associated with urothelial carcinoma

The first reported case of PERM associated with anti-glycine receptor antibodies in a patient with bladder cancer. PERM, a stiff-person syndrome, has paraneoplastic etiology in about 20% of cases.

Pathogenesis of spinal intramedullary lipomas

  • Open Access
  • Lipoma
  • Case Study

Spinal lipomas not associated with dysraphism are rare. Long-term close follow-up is important in young people with spinal lipomas, as they are more prone to an aggressive course.

Enterovirus A71-associated acute flaccid paralysis

A case of sudden onset of left arm paresis in a 13-month-old child, which was identified as a complication of enterovirus infection by PCR of a stool sample.

Treating progressive multifocal leukoencephalopathy in MS

The first report of filgrastim being used to treat PML secondary to fingolimod in a patient with relapsing–remitting multiple sclerosis, resulting in a favourable response.

PET-based imaging and fluorescence-guided surgery for recurrent, atypical meningioma

Using both 68-Ga Dotatoc PET-based imaging for surgical target planning and 5-ALA fluorescence-guided surgery can aid maximal microsurgical resection of a radiation-induced meningioma.

Glioblastoma treatment may increase neuronal damage in patients with Lewy body disease

A 77-year-old man developed rapid neurocognitive deterioration after resection, radiation, and chemotherapy for a glioblastoma and died suddenly. Lewy bodies in multiple subcortical regions indicates that treatment may have accelerated α-synuclein-induced neuronal damage.

Insulinoma with peripheral neuropathy

An unusual case in which the symptoms of peripheral neuropathy did not reverse completely after resection of the insulin-secreting tumor.

Cavernous hemangioma of the cisternal segment of the auditory nerve

Cavernous angiomas of the cranial nerves are extremely rare. Early diagnosis is crucial for complete resection of the lesion and to help preserve neurological function.