Tissue is the issue

BJMO - volume 15, issue 1, january 2021

M. Kukhalashvili MD, JB. Vermorken MD, PhD, T. van den Wyngaert MD, PhD, A. Snoeckx MD, M. Lammens MD, PhD, M. Peeters MD, PhD, P. Specenier MD, PhD


Multimodal therapy, including preoperative chemoradiotherapy followed by total mesorectal excision, has become the standard treatment for patients with locoregionally advanced rectal cancer.1 We report on a 54- year old female patient with rectal adenocarcinoma cT3N0M0, who was treated with neoadjuvant chemo-radiotherapy (capecitabine 825 mg/m² BID 5 days/week + 45 Gy in 25 fractions) followed by total mesorectal excision and adjuvant capecitabine for six months. Eleven weeks after the start of adjuvant capecitabine, she presented with dyspnoea, non-productive cough, shortness of breath, chest wall pain, and decrease of physical activity, for which she was admitted to the Antwerp University Hospital (UZA) in Edegem. Computed tomography (CT) revealed pulmonary emboli, enlarged mediastinal and hilar lymph nodes, and multiple micronodules in both lungs. Radiologic findings were suggestive of metastatic lymph nodules and numerous pulmonary metastases. However, pathological diagnosis showed nude granulomas without necrosis without evidence of tumour. Our case illustrates that sarcoid-like lesions may mimic lung metastases in cancer patients being treated with chemotherapy and that tissue still remains the issue.

(BELG J MED ONCOL 2021;15(1):40-3)

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TPFE (docetaxel, cisplatin, 5-FU and cetuximab) for recurrent mucoepidermoid carcinoma of the parotid gland: an aggressive strategy for an aggressive disease

BJMO - volume 11, issue 8, december 2017

A.R. Garcia MD, C. van Laer MD, D. van den Weyngaert MD, T. van den Wyngaert MD, PhD, M. Lammens MD, PhD, P. Specenier MD, PhD, J.B. Vermorken MD, PhD


The prognosis of patients with advanced malignant salivary gland cancer is usually poor. Systemic therapy combined with best supportive care is recommended for patients with metastatic or recurrent advanced salivary gland cancer ineligible for surgery or radiotherapy. Sensitivity to chemotherapy is thought to be histotype specific. However, to date, none of the systemic therapies, whether cytotoxic or non cytotoxic, can be considered standard for these tumours.

We report the case of a 43 year-old male patient with a third (loco)regional recurrence and metastases in lymph nodes below the clavicles of a mucoepidermoid carcinoma of the right parotid gland. He participated in a feasibility study and was treated with 3-weekly cycles of docetaxel, cisplatin, 5-fluorouracil plus weekly cetuximab (TPFE). After four TPFE cycles, additional radiation was given to the left neck. A complete response was reached which is ongoing for ten years. TPFE induced acute toxicities: skin rash grade 3, hypotension grade 3, neutropenia grade 3, anaemia grade 2 and alopecia grade 2. This observation underlines the importance of offering patients the possibility to participate in clinical trials. International collaboration for rare head and neck cancers, such as mucoepidermoid carcinoma, is urgently needed.

(BELG J MED ONCOL 2017;11(8):386-392)

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The RANK ligand inhibitor denosumab as novel therapeutic agent in the spectrum of cancer bone disease

BJMO - volume 6, issue 4, september 2012

T. van den Wyngaert MD, PhD, M.T. Huizing

Recently, the monoclonal antibody denosumab has been registered as a new first-in-class treatment option for the prevention of skeletal-related events (SREs) in patients with bone metastases from a solid tumour, for the treatment of treatment-induced bone loss (TIBL) in prostate cancer, and the treatment of post-menopausal osteoporosis. The present article reviews the mechanism of action of denosumab and the research leading to the registered indications in cancer patients. (BELG J MED ONCOL 2012;6:118–123)

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