Accidental Extravasation of Mitomycin C into the Subcutaneous Tissue.

Introduction: Mitomycin C (MMC) is a common chemotherapeutic agent used to treat a variety of solid tumors. Cutaneous adverse events are rare, but MMC is a known vesicant reported to cause tissue necrosis and sloughing, erythema, and ulceration if incorrectly infused into the subcutaneous tissue. Definitive treatment of extravasation injuries due to MMC depends on the severity of the cutaneous manifestation, which includes stopping the infusion, removing the catheter, or possible debridement. Case Presentation: We present the case of a 70-year-old female with extensive soft-tissue injury secondary to extravasation of MMC that required hospital admission and surgical intervention to remove the implantable venous access device. Conclusion: Extravasation injuries caused by vesicant drugs, such as MMC, often present as local skin irritation and inflammation. MMC extravasation may present a wide range of skin and soft tissue manifestations, ranging from erythema to ulcerations to necrosis. This rare but potentially detrimental complication of chemotherapy infusions should be recognized in cancer patients.

Catching the GIST: Massive Gastrointestinal Stromal Tumor Presenting as Acute Dyspnea.

We present a case of a 55-year-old woman presenting with worsening shortness of breath and constipation over the course of three days. Initial computed tomography scan showed a large, complex abdominal mass with a vascular pedicle and possible pedunculated origin along the inferior aspect of the greater curvature of the stomach. The mass was further evaluated on magnetic resonance imaging showing an active hemorrhage. The patient became hemodynamically unstable and general surgery was consulted for evaluation. Mass resection was performed, and biopsy revealed KIT/CD117+ and DOG1/ANO1+ gastrointestinal stromal tumor staged as T4. Although definitive diagnosis of a gastrointestinal stromal tumor requires biopsy, prompt clinical and radiological recognition is critical for patients to receive definitive treatment of mass resection.

Thyroid Steal Syndrome Secondary to Active Hyperthyroid State.

Thyroid steal syndrome (TSS) is a rare condition characterized by recurrent transient ischemic attack (TIA) that is found to be due to a large thyroid goiter or thyroid hormone derangement causing a diversion of blood flow from the cerebral circulation. Here we report a patient with a history of multiple TIAs thought initially to be due to intracranial arterial stenosis based on CT angiography (CTA) findings, but later found to be secondary to hyperthyroid state causing TSS. To our knowledge, this is the first-ever reported case of TSS secondary to hyperthyroidism and only the second case of TSS secondary to any thyroid hormone derangement.