1/4. tumor lysis syndrome following hemi-body irradiation for metastatic breast cancer.tumor lysis syndrome (TLS) is a rare serious acute complication of cancer therapy, reported mainly following chemotherapy in patients with large tumor load and chemosensitive disease. These are mainly patients with non-Hodgkin's lymphoma, leukemia and rarely in solid tumors. It is less frequently described after radiotherapy for lymphoid and hematological malignancies. TLS following radiotherapy for solid tumors is a very rare complication. In this report/review we describe a seventy-three-year-old male patient with progressive metastatic carcinoma of the breast to the lungs, liver and bone. He was referred for radiotherapy because of generalized bony pains. The patient was planned for sequential hemi-body irradiation starting with the more symptomatic upper half body. After premedication, he was given 8.5 Gy to the mid point at the maximum chest separation with anterior lung attenuator limiting uncorrected lung dose to 6.15 Gy. A further 3.5 Gy electron boost to the fungating breast tumor was given to the 100%. Forty-eight hours after irradiation he developed hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia and renal failure. These clinical and biochemical changes are typical of tumor lysis syndrome (TLS). Despite hydration, and treating the hyperuricemia, the patient developed coma and died eight days after irradiation. The prophylaxis and management of TLS and in high-risk patients are described to avoid this frequently fatal complication.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
2/4. gynecomastia with marked cellular atypia associated with chemotherapy.gynecomastia is a common benign male breast disease, which may exhibit mild cellular atypia in cytology specimens. However, marked cytologic atypia can be seen in gynecomastia superimposed by chemotherapy. The case described in this report demonstrated severe cytologic atypia of gynecomastia mimicking carcinoma in a patient treated with chemotherapy for acute leukemia. A distinct cytologic feature helpful in avoiding the diagnostic error is described, namely, atypical cells admixed with bland ductal cells and appearing at a different plane. The importance of applying strict diagnostic criteria in breast cytology and clinical correlation is also emphasized.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
3/4. breast cancer in a male patient after treatment of acute lymphoblastic leukemia including total body irradiation and bone marrow transplantation.BACKGROUND: With increasing numbers of patients subjected to total body irradiation and bone marrow transplantation for treatment of several systemic malignancies more and more patients with second malignancies were observed. CASE REPORT: We report the case of a 29- year-old man who developed breast cancer 13 years after treatment for acute lymphoblastic leukemia. Therapy for leukemia included total body irradiation (TBI) and bone marrow transplantation (BMT). breast cancer was treated with mastectomy and irradiation of the left chest wall. 17 months later the patient developed malignant pleural effusion and died despite chemotherapy and hormonal therapy due to further tumor progression. CONCLUSION: The increased risk for secondary solid cancers after TBI and BMT and the greater risk among younger patients indicate the need for lifelong careful follow up.- - - - - - - - - - ranking = 6keywords = leukemia (Clic here for more details about this article) |
4/4. Metastatic disease in the breast from nonmammary neoplasms.breast cancer is the leading cause of death from cancer in women. The metastatic involvement of the breast from nonmammary neoplasms is a relatively rare condition. female patients are affected five to six times more frequently than male patients. We present seven patients with metastasis in the breast from extramammary tumors. Females seemed to be more frequently affected (6 women and 1 man) and included a wide range of ages (17-70 years old). All female patients had suspicious-looking abnormalities (B1-RADS 4) or lesions highly suspicious of malignancy (BI-RADS 5) in the mammography, without a confirmative fine needle aspiration cytology. The primary malignancies were equally distributed between non-hematological (1 renal adenocarcinoma, 1 melanoma, 1 leiomyosarcoma) and hematological (1 non-Hodgkin's, 2 Hodgkin's lymphomas and 1 leukemia). Treatment is therefore modified, taking into consideration the treatment and prognosis of the primary disease.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |