RESUMEN
Immunotherapy is a relatively new approach for cancer treatment that has demonstrated prolonged survival by enhancing the body's immunologic response among advanced cancer patients. Although the benefits of immunotherapy have been well documented, potentially detrimental consequences such as pseudoprogression and hyperprogression have been identified. Hyperprogression is a tumor response in which the existing underlying tumor grows rapidly after initiating treatment with an immune checkpoint inhibitor. This report presents a case of hyperprogression of non-small-cell lung cancer in a 71-year-old male who was initially treated with four cycles of chemotherapy (carboplatin and pemetrexed) and later started on maintenance therapy with pembrolizumab and chemotherapy. Two weeks after receiving the first cycle of immunotherapy, he presented with a complaint of shortness of breath. On repeat computed tomography of the chest, he was found to have a two-fold increase in the size of the preexisting tumor with new large multiloculated right pleural effusion and abdominal ascites.
RESUMEN
Extranodal mucosa-associated lymphoid tissue (MALT) is a type of non-Hodgkin's lymphoma (NHL). It commonly involves the GI tract, but the involvement of the urinary bladder is very rare. It comprises less than 1% of bladder tumors and 0.2% of extranodal lymphomas. Fewer than a hundred cases are reported so far and limited literature is available on the management. Here we are presenting a gentleman with MALT lymphoma of the urinary bladder who presented with urinary frequency, an urgency which was initially managed as benign prosthetic hyperplasia. Initially, the treatment helped him with improvement in his symptoms. After a recurrence of his symptoms 11 years later, he underwent cystoscopy with biopsy that revealed MALT lymphoma of the bladder and underwent radiotherapy.