RESUMO
Uterine leiomyosarcoma (uLMS) is a rare but aggressive cancer with a high metastatic potential and an unfavorable prognosis. A 54-year-old woman with a history of uterine fibroids clinically presented with a painless, palpable left breast mass measuring 20 mm. A core biopsy of the breast mass demonstrated a cellular spindle cell neoplasm (a potentially malignant smooth muscle neoplasm; B4). A wide local breast-mass excision was performed, revealing grade-2 leiomyosarcoma. A re-review of the uterine fibroids revealed that the largest one (200 × 130 mm), initially diagnosed as symplastic leiomyoma, was morphologically identical to the breast lesion. Additional diagnostic work-up revealed multiple liver and pulmonary metastases with a suspected metastatic sclerotic lesion in the L3 projection. The patient was subsequently treated with chemotherapy protocol for metastatic uLMS. The latest follow-up in September 2023 confirmed stable disease. This case highlights the importance of considering unusual metastatic patterns when evaluating breast masses, particularly in patients with a history of non-specific uterine conditions. Comprehensive diagnostic work-up, including imaging and histopathologic examinations, is crucial for an accurate diagnosis of uLMS and appropriate treatment selection. Further studies are needed to better understand the underlying mechanisms and optimal management strategies for metastatic uLMS.
Assuntos
Leiomioma , Leiomiossarcoma , Neoplasias Pulmonares , Feminino , Humanos , Pessoa de Meia-Idade , Leiomiossarcoma/diagnóstico por imagem , Protocolos de Quimioterapia Combinada Antineoplásica , FígadoRESUMO
BACKGROUND: The optimal duration of ixabepilone and capecitabine chemotherapy combination is currently not known and will most likely be patient-specific based on efficacy, toxicity, quality of life, and patient preference. CASE REPORT: We report an extremely long duration of chemotherapy with ixabepilone and capecitabine (42 cycles) in a patient with triple-negative metastatic breast cancer previously treated with anthracyclines and taxanes. Partial remission was achieved, and acceptable toxicity was observed. CONCLUSIONS: This report adds to the pool of knowledge regarding the use of this important new metastatic breast cancer regimen, especially with respect to the optimal duration of its use.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal/secundário , Carcinoma Papilar/secundário , Neoplasias Pulmonares/secundário , Segunda Neoplasia Primária/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Biomarcadores Tumorais/genética , Neoplasias da Mama/genética , Capecitabina , Carcinoma Ductal/tratamento farmacológico , Carcinoma Ductal/genética , Carcinoma Papilar/tratamento farmacológico , Carcinoma Papilar/genética , Terapia Combinada , Desoxicitidina/administração & dosagem , Desoxicitidina/efeitos adversos , Desoxicitidina/análogos & derivados , Progressão da Doença , Relação Dose-Resposta a Droga , Esquema de Medicação , Epotilonas/administração & dosagem , Epotilonas/efeitos adversos , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Fluoruracila/análogos & derivados , Seguimentos , Humanos , Assistência de Longa Duração , Neoplasias Pulmonares/tratamento farmacológico , Pessoa de Meia-Idade , Segunda Neoplasia Primária/genética , Ensaios Clínicos Controlados Aleatórios como Assunto , Receptor ErbB-2/genética , Receptores de Estrogênio/genética , Receptores de Progesterona/genéticaRESUMO
OBJECTIVE: We present a patient with metastatic melanoma who had a complete response to second line chemotherapy with paclitaxel and carboplatin. CASE REPORT: Metastatic melanoma is an aggressive cancer with poor prognosis and 10 year survival less than 10%. We present a patient with metastatic melanoma who had a complete response to second line chemotherapy with paclitaxel and carboplatin. CONCLUSION: Second line chemotherapy with paclitaxel and carboplatin in the treatment of metastatic melanoma may yield effective results.