Articles

Nivolumab/ipilimumab-induced cerebral vasculitis in stage IIIc melanoma: A case report

BJMO - volume 17, issue 4, june 2023

E. van Gogh MD, L. Baisier MD, P. Reyntiens MD, J. Liu MD, M. Rasschaert MD

SUMMARY

Immunotherapy has revolutionised cancer therapy for specific tumour types. The dismal prognosis of melanoma patients with advanced stage has improved but remains poor. With the increasing use of these monoclonal antibodies, toxicities are becoming more prevalent. Neurological adverse events are still rare but have an enormous impact on the continuum of care. This study reports a case of a 70-year-old man with stage IIIc melanoma who presented with cerebral vasculitis after rechallenge therapy with ipilimumab/nivolumab.

(Belg J Med Oncol 2023;17(4):128–31)

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Adenocarcinoma of the ampulla of Vater with leptomeningeal and colonic metastasis: A case report

BJMO - volume 16, issue 3, may 2022

L. Baisier MD, A. Buttiens MD, A. Eyben MD, M. Viaene MD, H. De Cauwer MD

SUMMARY

Adenocarcinoma of the ampulla of Vater is a biliary tumour arising from the distal biliary epithelium at the ampulla of Vater. It is a relatively rare tumour, accounting for approximately 7% of all periampullary malignancies. Leptomeningeal metastasis, a complication occurring in 5% of all cancer patients, is a feature very seldomly reported in this type of malignancy. The prognosis is very poor, as current treatment options for leptomeningeal metastasis are limited by low efficacy and high toxicity. This study presents the case of a patient with an ampullary adenocarcinoma, who first was treated with surgical resection for localised disease. However, the disease evolved and palliative chemotherapy was started when colonic metastases became evident. Twelve months after diagnosis, leptomeningeal metastases were detected. To our knowledge, only one similar case has been reported previously, slightly different from the type of ampullary carcinoma presented in this study. Leptomeningeal metastasis should always be considered in a patient presenting with neurologic signs and a history of an ampullary malignancy.

(BELG J MED ONCOL 2022;16(3):125–7)

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