RESUMEN
Background: Angiosarcoma is a rare and aggressive tumor of vascular endothelial origin. Pulmonary metastasis can lead to potential life-threatening complications, such as bleeding and pneumothorax.Methods: We report on a 82-year-old male with major hemoptysis, recurrent hemopneumothorax and cystic lung lesions.Results: Although initial diagnostic findings were misleading, thoracoscopic exploration revealed pulmonary and pleural metastasized angiosarcoma.Conclusion: The presence of hemoptysis or (recurrent) hemopneumothorax associated with cystic lung lesions should alert the clinician of possible pulmonary metastasized angiosarcoma.
Asunto(s)
Neoplasias de Cabeza y Cuello/patología , Hemangiosarcoma/complicaciones , Hemoneumotórax/etiología , Hemoptisis/etiología , Neoplasias Pulmonares/complicaciones , Neoplasias Pleurales/complicaciones , Cuero Cabelludo , Neoplasias Cutáneas/patología , Anciano de 80 o más Años , Hemangiosarcoma/diagnóstico , Hemangiosarcoma/secundario , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundario , Masculino , Neoplasias Pleurales/diagnóstico , Neoplasias Pleurales/secundario , Recurrencia , Toracoscopía , Tomografía Computarizada por Rayos XRESUMEN
Epidermal growth factor receptor (EGFR)-targeted therapy has become standard of care in advanced stages EGFR-mutant non-small cell lung cancer. Acquired resistance to first-line EGFR-tyrosine kinase inhibitor (TKI) and subsequent disease progression is a common problem and mostly due to a secondary mutation (T790M) in EGFR. We report a case of a patient with EGFR-mutated lung adenocarcinoma who developed a complex resistance profile: T790M mutation, HER2 mutation and HER2 amplification after first-line EGFR-TKI. This patient was safely treated with a combination of osimertinib and trastuzumab and achieved a clinically meaningful and clear molecular response. This is the first reported case of acquired resistance to first-line EGFR-TKI based on three resistance mechanisms, treated with molecular targeted combination therapy.
RESUMEN
Liver failure is reported with increasing frequency in patients who underwent bariatric surgery for morbid obesity. In most cases, liver transplantation is the only possible treatment to avoid fatal outcome. Although most cases are observed after older bariatric surgery techniques characterized by high malabsorption rates, we report on a 38-year-old woman who developed liver failure seven months after long-limb gastric bypass.