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Vermeersch G, Cruyt N, D'Hondt E, Geers J, Hertveldt K, Stockman A, Lambrecht G. Granulomatous peritoneal disease associated with oxaliplatin-based chemotherapy for ampullary adenocarcinoma: a case report. Acta Gastroenterol Belg 2023; 86:499-501. [PMID: 37814569 DOI: 10.51821/86.3.11323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Adenocarcinomas of the ampulla of Vater represent only 0.2% of all gastrointestinal cancers. Due to the low incidence no large clinical trials evaluating efficacy of treatments are available. Adjuvant therapy is often administered in patients with stage IB or higher. Oxaliplatin is considered as an effective and well tolerated therapeutic option. Adverse events associated with this therapy include cardio-, neuro-, nephrotoxicity and myelosuppression. Previously granulomatous pulmonary and liver manifestations have been described in oxaliplatin-based chemotherapy. In this report peritoneal manifestation of granulomatous disease associated with oxaliplatin is described for the first time. Sarcoidlike reactions may be misinterpreted as tumour progression or metastatic disease, and may consequently result in over-treatment.
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Affiliation(s)
- G Vermeersch
- Department of Gastroenterology and Digestive Oncology, AZ Damiaan, Oostende, Belgium
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - N Cruyt
- Department of Gastroenterology and Digestive Oncology, AZ Damiaan, Oostende, Belgium
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - E D'Hondt
- Department of Nuclear Medicine, AZ Damiaan, Oostende, Belgium
| | - J Geers
- Department of General and Abdominal Surgery, AZ Damiaan, Oostende, Belgium
| | - K Hertveldt
- Department of Anatomopathology, AZ Damiaan, Oostende, Belgium
| | - A Stockman
- Department of Radiology, AZ Damiaan, Oostende, Belgium
| | - G Lambrecht
- Department of Gastroenterology and Digestive Oncology, AZ Damiaan, Oostende, Belgium
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Sarcoidosis-like disease with pulmonary infestation, meningoencephalitis and transverse myelitis after sigmoid cancer treatment. Acta Gastroenterol Belg 2021; 84:672-674. [PMID: 34965052 DOI: 10.51821/84.4.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We present the case of a 40-year-old male with recent history of moderately differentiated invasive adenocarcinoma of the sigmoid in whom both respiratory and neurological disease developed simultaneously, mimicking diffuse metastatic disease. The broad differential diagnosis and pitfalls (both diagnostic and therapeutic) are described. Pulmonary sarcoidosis as well as neurosarcoidosis occur very rarely after solid cancers.
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Dundar A, Dundar B, Inanc M, Canoz O, Oymak FS, Abdulrezzak U. Sarcoidosis with Multiorgan Involvement and Cutaneous Manifestations after Colonic Adenocarcinoma Resection. Indian J Nucl Med 2019; 34:226-229. [PMID: 31293305 PMCID: PMC6593942 DOI: 10.4103/ijnm.ijnm_89_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Sarcoidosis is a systemic chronic granulomatous disease. It mostly involves the lungs and hilar lymph nodes and produces epithelioid granulomas. Granulomatous (sarcoid) reaction is known to be associated with malignancies; however, it is uncommonly seen with colon carcinomas. Furthermore, systemic sarcoidosis following cancer diagnosis is less commonly seen. To the best of our knowledge, cutaneous sarcoidosis related with an underlying colon carcinoma has not been reported previously in the literature. In this report, we present a very rare case with sarcoidosis development after resection of sigmoid adenocarcinoma, presenting with multiorgan involvement including the skin, eye, joints, and lymph nodes. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) images showed the skin, lung, spleen, mediastinal, and hilar lymph node involvement. Histopathological examination of skin lesions demonstrated granulomatous dermatitis. This case demonstrates that sarcoidosis can cause intensely FDG-avid lesions on 18F-FDG-PET/CT scans, mimicking metastasis in colon cancer patients. Histopathological evaluation is essential for confirming the diagnosis. 18F-FDG-PET/CT scan provides important information for evaluation of disease extension, progression, and clinical follow-up.
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Affiliation(s)
- Ayca Dundar
- Department of Nuclear Medicine, Erciyes University, Kayseri, Turkey
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Bilge Dundar
- Department of Pathology, Erciyes University, Kayseri, Turkey
- Department of Pathology, Northwestern University, Chicago, IL, USA
| | - Mevlude Inanc
- Department of Internal Medicine, Division of Oncology, Erciyes University, Kayseri, Turkey
| | - Ozlem Canoz
- Department of Pathology, Erciyes University, Kayseri, Turkey
| | - Fatma Sema Oymak
- Department of Pulmonary Medicine, Erciyes University, Kayseri, Turkey
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Stanziola AA, Caccavo G, De Rosa N, D'Amato M, Saggar R, Spadaro G, Ponticiello A. Sarcoidosis and colon cancer: a possible association. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2018; 35:376-380. [PMID: 32476926 PMCID: PMC7170125 DOI: 10.36141/svdld.v35i4.7191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/24/2018] [Indexed: 11/02/2022]
Abstract
Sarcoidosis is a multisystem inflammatory disease characterized by non-caseating granulomas which mainly affect the pulmonary lymphatic system and lungs; although any organs can be interested. The association between sarcoidosis and cancer is still controversial, but many studies demonstrated an increased risk of cancer in patients with sarcoidosis, whereas few cases of sarcoidosis occurring after cancer have been reported. This report outlines and describes clinical, biologic and radiologic features of 3 patients with a history of surgical treatment and adjuvant chemotherapy for colon cancer, followed by a diagnosis of sarcoidosis some years later. The history of cancer and the lymph nodes positivity found through PET scan induced us to hypothesize a relapsing cancer disease. However, this hypothesis was not confirmed by the lymph nodes biopsy, which is the core method of diagnosis of sarcoidosis. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 376-380).
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Affiliation(s)
| | - Giovanna Caccavo
- Univ Naples Federico II, Dept Clin Med and Surg, Sect Resp Dis, Naples, Italy
| | | | - Maria D'Amato
- Univ Naples Federico II, Dept Clin Med and Surg, Sect Resp Dis, Naples, Italy
| | - Rajeev Saggar
- Advanced Lung Disease Institute Banner University Medical Center-Phoenix, Univ. of Arizona, Phoenix
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples. Italy
| | - Antonio Ponticiello
- Univ Naples Federico II, Dept Clin Med and Surg, Sect Resp Dis, Naples, Italy
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De Weerdt A, Dendooven A, Snoeckx A, Pen J, Lammens M, Jorens PG. Prognosis and treatment of FOLFOX therapy related interstitial pneumonia: a plea for multimodal immune modulating therapy in the respiratory insufficient patient. BMC Cancer 2017; 17:586. [PMID: 28851379 PMCID: PMC5576105 DOI: 10.1186/s12885-017-3576-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/22/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The FOLFOX regimen, i.e., folinic acid (FOL), fluorouracil (F) and oxaliplatin (OX), is a drug cocktail that is used to treat gastric and colorectal cancers. Despite the concomitant improvements in response rate, duration of response and patient survival, reports of serious toxic pulmonary side effects have progressively emerged. CASE PRESENTATION We describe a patient who was treated with FOLFOX as an adjuvant to a rectosigmoidal resection of a rectosigmoidal carcinoma and who developed respiratory insufficiency requiring mechanical ventilation. Computed tomography (CT) imaging and open lung biopsy findings were compatible with interstitial pneumonia (IP). She received multimodal combination treatment (acetylcysteine, corticosteroids, immune globulins and cyclophosphamide) and survived. We performed a systematic literature search and reviewed all 45 reported cases of FOLFOX-related lung toxicity and/or pulmonary fibrosis for their clinical characteristics and their outcomes related to therapy. CONCLUSIONS We found that for the 45 cases with available data, the median age was 70 years, and the male-female ratio was 3.5: 1. In the patients exhibiting only mild respiratory symptoms, discontinuation of the culprit drug (oxaliplatin) resulted in a 100% regression of the symptoms. However the prognosis of the respiratory insufficient patient proved to be grim: death occurred in 76.9% of the cases despite conventional treatment with corticosteroids. We therefore urge oncologists and critical care specialists not to limit their interventions to the discontinuation of chemotherapy, artificial ventilation, corticosteroids and glutathione replenishment and to consider the gradual introduction of additional immune-modulating agents whenever life-threatening respiratory symptoms in oxaliplatin-treated patients do not subside; all the more so considering the fact that our analysis showed that every patient who survived intubation and mechanical ventilation experienced a full clinical recovery.
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Affiliation(s)
- Annick De Weerdt
- Department of Intensive Care Medicine, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium.
| | - Amélie Dendooven
- Department of Pathology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Annemie Snoeckx
- Department of Radiology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Jan Pen
- Department of Gastroenterology, Heilig Hart Hospital, Lier, Belgium
| | - Martin Lammens
- Department of Pathology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Philippe G Jorens
- Department of Intensive Care Medicine, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium
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Grados A, Ebbo M, Bernit E, Veit V, Mazodier K, Jean R, Coso D, Aurran-Schleinitz T, Broussais F, Bouabdallah R, Gravis G, Goncalves A, Giovaninni M, Sève P, Chetaille B, Gavet-Bongo F, Weitten T, Pavic M, Harlé JR, Schleinitz N. Sarcoidosis Occurring After Solid Cancer: A Nonfortuitous Association: Report of 12 Cases and Review of the Literature. Medicine (Baltimore) 2015; 94:e928. [PMID: 26181571 PMCID: PMC4617083 DOI: 10.1097/md.0000000000000928] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The association between cancer and sarcoidosis is controversial. Some epidemiological studies show an increase of the incidence of cancer in patients with sarcoidosis but only few cases of sarcoidosis following cancer treatment have been reported. We conducted a retrospective case study from internal medicine and oncology departments for patients presenting sarcoidosis after solid cancer treatment. We also performed a literature review to search for patients who developed sarcoidosis after solid cancer. We describe the clinical, biological, and radiological characteristics and outcome of these patients. Twelve patients were included in our study. Various cancers were observed with a predominance of breast cancer. Development of sarcoidosis appeared in the 3 years following cancer and was asymptomatic in half of the patients. The disease was frequently identified after a follow-up positron emission tomography computerized tomography evaluation. Various manifestations were observed but all patients presented lymph node involvement. Half of the patients required systemic therapy. With a median follow-up of 73 months, no patient developed cancer relapse. Review of the literature identified 61 other patients for which the characteristics of both solid cancer and sarcoidosis were similar to those observed in our series. This report demonstrates that sarcoidosis must be considered in the differential diagnosis of patients with a history of malignancy who have developed lymphadenopathy or other lesions on positron emission tomography computerized tomography. Histological confirmation of cancer relapse is mandatory in order to avoid unjustified treatments. This association should be consider as a protective factor against cancer relapse.
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Affiliation(s)
- Aurélie Grados
- From the Department of Internal Medicine, CHU Timone, Assistance Publique-Hôpitaux de Marseille, Marseille (AG, ME, EB, VV, J-RH, NS); Department of Internal Medicine, CHU Conception, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille (KM, RJ); Department of Hematology, Paoli Calmette Institute, Marseille (DC, TA-S, FB, RB); Department of Oncology, Paoli Calmette Institute, Marseille (GG, AG, MG); Department of Internal Medicine, Croix-Rousse Hospital, Lyon (PS); Department of Pathology, Paoli Calmette Institute, Marseille (BC); Department of Internal Medicine, Alpes du Sud Hospital, Gap (FG-B, TW); and Department of Oncology, Desgenettes Hospital, Lyon (MP), France
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Jiao Y, Ning J, Zhao WDI, Li YL, Wu HY, Gu KS. Sarcoidosis in gastric cancer at the time of diagnosis: A case report. Oncol Lett 2015; 9:1159-1162. [PMID: 25663873 PMCID: PMC4315069 DOI: 10.3892/ol.2015.2850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/22/2014] [Indexed: 11/06/2022] Open
Abstract
Sarcoidosis is a multisystemic inflammatory disease that commonly affects the lungs and lymphatic system and is characterized by the formation of non-caseating granulomas. Although the association between sarcoidosis and malignant diseases has been well described, it remains controversial whether this association is merely a coincidence or the consequence of a common pathophysiological mechanism. The present study reports a rare case of sarcoidosis that was present in a patient with gastric cancer at the time of diagnosis. A 64-year-old female diagnosed with stage I gastric cancer underwent curative surgery, and the postoperative pathology of the lymph nodes revealed non-caseating granulomas. At the 4-year follow-up, the sarcoidosis remained stable, and no recurrence of cancer was identified. The present case revealed that sarcoidosis and gastric cancer may coexist simultaneously and focused on the potential advantages of histological confirmation in patients with cancer and sarcoidosis.
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Affiliation(s)
- Yang Jiao
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Jie Ning
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Wen-DI Zhao
- Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Yan-Li Li
- Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, P.R. China
| | - Hong-Yang Wu
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Kang-Sheng Gu
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
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