Inflammatory breast cancer (IBC) is a relatively rare and aggressive subtype, accounting for nearly 2.5% of all diagnosed breast cancers worldwide. It is usually characterised by an acute onset, rapid clinical progression, poor prognosis and micrometastasis at the time of presentation. Prompt recognition of clinical symptoms and identification of warning signs are vital in diagnosing and appropriately treating a patient with IBC.
Abstract:We report a case of 60 year old male with nasopharyngeal squamous cell carcinoma T2N3aMo treated with concurrent chemo-radiation 66Gy in 30 fractions with concurrent weekly carboplatin. On 1 year follow up, the patient had residual left level Ⅱnode, for which 6 cycles of Paclitaxel, cisplatin and 5-Fluorouracil (TPF) was given. Following one year disease free interval, the cancer recurred on same left level II region, for which left Modified Radical Neck Dissection was done. Post-operative re-irradiation 60 Gy in 30 fractions was given in view of extracapsular extension. After a disease free interval of 8 months, recurrence was found in nasopharynx and contralateral right level III nodal region. In our case, re-irradiation without chemotherapy has not improved disease free interval. Therefore, systemic chemotherapy along with re-irradiation should be considered for isolated nodal recurrence with extracapsular extension. (Fig. 1A). Concurrent chemoradiation with
Background: In patients of cancer associated venous thromboembolism, low molecular weight heparin (LMWH) combined with a vitamin K antagonist is currently recommended as the first treatment of anticoagulation. Rivaroxaban, an oral direct factor Xa inhibitor, is attractive option in the cancer population, with their oral formulation, no need of monitoring. The purpose of this study is to evaluate efficacy and safety of rivaroxaban in patients with cancer associated venous thromboembolism. Methods: We performed a retrospective chart review in cancer patients for pulmonary embolism or deep vein thrombosis. Our analysis included all patients who received for rivaroxaban between March 1, 2013 to June 30, 2016 at Hemato-oncology division, Pusan National University Hospital in Korea. Results: Preliminary results identified 123 patients with a history of cancer that were treated with rivaroxaban. In solid tumor malignancy, the most common type of cancers identified were colo-rectal 13% (n ¼ 16), lung 13% (n ¼ 16), and stomach 8.1% (n ¼ 10). The average age of patients was 63.34, 42.3% of patients were male. During a mean follow up of 25.3 months, 56.9% (n ¼ 53) of patients diagnosed pulmonary thromboembolism, 58.5% (n ¼ 72) of patients diagnosed deep vein thrombosis, and 13.8% (n ¼ 17) of patients had both of them. Of the 123 included patients, 42.3% (n ¼ 52) of patients were classified as incidental venous thromboembolism and 57.7% (n ¼ 71) as symptomatic venous thromboembolism.The average duration of rivaroxaban therapy was 95.25 days. 35 patients resolved venous thromboembolism after initiation of rivaroxaban, only 1 patient recurred on rivaroxaban treatment. Major bleeding was observed in 4.8% (n ¼ 6) patients, and minor bleeding was observed in 8.9% (n ¼ 11) patients. The majority of bleeding events occurred spontaneously, and most of bleeding could be treated conservatively. Among 52 deaths patients (42.3%), none of patients died due to venous thromboembolism or bleeding complications, the majority of cause of death is cancer progression.
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