RESUMO
INTRODUCTION: New Immuno- Checkpoint inhibitors (ICIs) functioning as PD-1- PDL-1 blockers are nowadays used in a majority of anticancer treatments. Many immune- related Adverse Events (irAEs) are published daily; severe skin toxicities, Stevens Johnson/ Toxic Epidermal Necrolysis (SJS/TEN) are seldom reported. CASE REPORT: Herein, we present two interesting skin sever toxicity cases of lung cancer patients, undergoing PD-1- PDL-1 Immunotherapy. In both cases, a morbilliform rash with documented histological Toxic Epidermal Necrolysis Pattern /Stevens Johnson findings, was thoroughly studied. MANAGEMENT & OUTCOME: Both cases were therapeutically managed according to guidelines with different outcome. DISCUSSION: Two focused cases of irAEs, is the rationale, to briefly review mechanisms of major toxicities caused by PD-1/PD-L1 blockade, and present all new data in their precise management. ICIs' association with SJS/ TEN still remains unclear; underlying urgent need for further studies. It is important to alert physicians to promptly identify life threatening irAEs. Being familiar, provides management efficacy, safe resolve and encourage beneficial balanced cost effective treatments.
Assuntos
Neoplasias Pulmonares , Síndrome de Stevens-Johnson , Humanos , Síndrome de Stevens-Johnson/etiologia , Receptor de Morte Celular Programada 1 , Pele , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/complicações , Imunoterapia/efeitos adversosAssuntos
Adenocarcinoma/secundário , Neoplasias da Mama/patologia , Carcinoma Lobular/secundário , Neoplasias Gástricas/secundário , Adenocarcinoma/química , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Biópsia , Neoplasias da Mama/química , Carcinoma Lobular/química , Feminino , Humanos , Imuno-Histoquímica , Invasividade Neoplásica , Valor Preditivo dos Testes , Neoplasias Gástricas/químicaRESUMO
Primary lymphomas of the colon account for 0.5% of all primary colon malignancies. Burkitt´s lymphoma is a B-cell lymphoma with aggressive clinical behavior. Herein, we describe a case of a male patient who presented with signs of large bowel obstruction, underwent surgery and found to suffer from Burkitt´s lymphoma of the ileocecal region. The histopathological examination was indicative for Burkitt´s lymphoma. To the best of our insight this is one of the few reported cases of such type of lymphoma in an adult patient presenting with bowel obstruction. Burkitt´s lymphoma is a rare malignancy in adults affecting gastrointestinal tract. It has a high proliferation potential and can rapidly progress to advanced disease. Early diagnosis is necessary to prevent complications and improve overall prognosis.
