Key Clinical MessagePrimary apocrine sweat gland carcinoma is a rare neoplasm. It is usually slow growing and is often suspected to be a benign disease at initial assessment. A thorough clinical and histological workup is required for diagnosis. Treatment of choice is wide local excision with clear margins.
A 45-year-old female developed neurological symptoms and elevated diastolic blood pressure while on bevacizumab (Avastin) and gemcitabine for recurrent carboplatin-resistant high-grade serous ovarian cancer. A brain MRI diagnosed our patient with posterior reversible encephalopathy syndrome. We are discussing her presenting symptoms in this paper as well as the management and the outcome. We emphasize the importance of keeping this rare but very serious complication in all patients receiving bevacizumab.
Metastatic ovarian cancer to the breast is a rare presentation, with limited cases reported worldwide. Common sites for distant metastasis in ovarian cancer are to the liver, lung, and pleura [Dauplat et al. Cancer. 1987 Oct 1;60(7):1561-6]. Usually, such cases predict poor prognosis with troublesome management. We present one challenging case of a 54-year-old female patient with recurrent clear cell ovarian cancer, presenting with right breast mass of primary versus secondary origin, progressing into inflammatory breast cancer picture. Our report aims to shed light on the value of early suspicion and low threshold of detecting secondary breast masses of ovarian cancer origin.
Introduction The prevalence of psychosocial distress is up to 45% among cancer patients. It is crucial to identify and treat distress. The aim of the study is to report on the prevalence of distress among cancer patients, analyze the variable causes of distress and to study the effect of the disease stage using the Distress Thermometer. Methods We studied distress among 3 groups, each consisting of 100 patients: those initially diagnosed, patients undergoing treatment, and patients who were referred to the palliative team. Different variables such as time of screening, sex, age, nationality, and tumor type were analyzed.Results There was an overall distress incidence of 62% (level ≥ 4) and out of that 17% of the patients had severe distress (level >7). Similarly, there was 75% of distress among patients who were referred to palliative care, compared to 56% of patients at initial diagnosis and 54% for those undergoing cancer treatments. In addition, women (69%) had more distress (53%). Expatriates had high distress, compared to Qataris (64.3% versus 51%). Breast (69%) and lung (70%) cancer patients had the highest level of distress. Physical causes of distress were the most common followed by emotional causes.Conclusion There is a substantially higher overall incidence of distress among cancer patients in Qatar. Distress should be assessed in patients at cancer diagnosis and at the time of disease progression. Screening alone isn’t enough, the different causes of distress should be identified and addressed by the appropriate interventions.
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Introduction The prevalence of psychosocial distress is up to 45% among cancer patients. It is crucial to identify and treat distress. The aim of the study is to report on the prevalence of distress among cancer patients, analyze the variable causes of distress and to study the effect of the disease stage using the Distress Thermometer.Methods We studied distress among 3 groups, each consisting of 100 patients: those initially diagnosed, patients undergoing treatment, and patients who were referred to the palliative team. Different variables such as time of screening, sex, age, nationality, and tumor type were analyzed.Results There was an overall distress incidence of 62% (level ≥ 4) and out of that 17% of the patients had severe distress (level >7). Similarly, there was 75% of distress among patients who were referred to palliative care, compared to 56% of patients at initial diagnosis and 54% for those undergoing cancer treatments. In addition, women (69%) had more distress (53%). Expatriates had high distress, compared to Qataris (64.3% versus 51%). Breast (69%) and lung (70%) cancer patients had the highest level of distress. Physical causes of distress were the most common followed by emotional causes. Conclusion There is a substantially higher overall incidence of distress among cancer patients in Qatar.Distress should be assessed in patients at cancer diagnosis and at the time of disease progression.Screening alone isn't enough, the different causes of distress should be identi ed and addressed by the appropriate interventions.
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