Parasitic leiomyomas (PMs) are rare extrauterine benign smooth muscle tumors that can arise spontaneously or develop iatrogenically following prior uterine surgery, particularly with morcellation of uterine tissue. We present a case of a 49‐year‐old woman who developed multiple recurrent PMs involving the abdominal cavity, appendix, and abdominal wall over several years following laparoscopic myomectomy with morcellation and subsequent hysterectomy. At her most recent intra‐abdominal recurrence, she underwent a bilateral oophorectomy at the time of tumor resection. This case highlights the potential for delayed recurrence of parasitic myomas even years after hysterectomy and supports the importance of clinical vigilance and imaging in symptomatic patients with prior morcellation. It also supports consideration of and further study of the role of estrogen suppression in preventing recurrence.
Introduction Persistent fever in patients with cancer presents a significant diagnostic challenge, particularly in settings where infectious diseases are highly prevalent. Neoplastic fever is an important noninfectious cause of fever that may mimic infection and result in unnecessary investigations, antimicrobial therapy, and delays in cancer treatment. Case Presentation We report a case of a 45‐year‐old female patient with advanced cervical carcinoma who presented with persistent high‐grade fever unresponsive to antibiotics. An extensive infectious workup was negative. Following exclusion of alternative causes, a naproxen challenge was performed, resulting in rapid resolution of fever within 24 h. Fever recurred upon withdrawal and resolved again after naproxen reintroduction, supporting the diagnosis of neoplastic fever. Conclusion Neoplastic fever should be considered early in cancer patients with persistent unexplained fever, particularly in tuberculosis‐ and malaria‐endemic settings. Following exclusion of infection, the naproxen challenge may provide a simple and affordable diagnostic step to distinguish neoplastic fever from infectious causes, reduce unnecessary antimicrobial use, shorten diagnostic delays, and facilitate timely cancer‐directed therapy.
Lenalidomide is widely used for the treatment and maintenance of multiple myeloma and is generally considered to have a favorable safety profile. However, severe skeletal muscle toxicity associated with lenalidomide has been rarely reported. We describe a 52-year-old man with multiple myeloma who developed acute bilateral lower-extremity pain, cramping, weakness, and paresthesia while receiving lenalidomide therapy. Laboratory evaluation revealed marked rhabdomyolysis, and imaging and clinical findings were consistent with bilateral lower-leg compartment syndrome. Despite emergent bilateral fasciotomies resulting in resolution of pain and normalization of creatine kinase levels, the patient developed persistent bilateral foot drop with residual sensory deficits. To our knowledge, this represents the first reported case of lenalidomide-associated rhabdomyolysis progressing to bilateral compartment syndrome with permanent neurologic sequelae. This case underscores the importance of early recognition of muscle toxicity, prompt laboratory evaluation, and timely surgical intervention to mitigate irreversible functional impairment.
Background:Small cell neuroendocrine carcinoma of the prostate (SCNEC) is a rare but devastatingly aggressive malignancy, carrying a median survival well under 13 months even with multimodal treatment. It may arise de novo or emerge as a treatment-resistance phenotype following androgen deprivation in conventional prostatic adenocarcinoma. A defining and clinically treacherous feature is its failure to elevate serum PSA in proportion to tumour burden-a phenomenon termed the 'PSA paradox'-which routinely delays diagnosis, particularly in resource-limited settings. Case Presentation:We report a 35-year-old Bangladeshi man who presented with obstructive urinary symptoms, constipation and deep pelvic pain. His serum PSA was only 0.77 ng/mL despite a 6.5 × 6.0 × 5.5 cm prostate mass with liver metastases, extensive osteoblastic bone deposits (SUVmax ~18 on 18F-FDG PET/CT), left hydronephrosis and regional lymphadenopathy. Initial TRUS-guided biopsy was reported as Gleason 5 + 5 = 10 adenocarcinoma. Given the PSA-disease burden mismatch, biopsy slides were immediately re-evaluated; haematuria and acute urinary retention necessitated urgent TURP on 4 December 2024, which confirmed a pure de novo SCNEC with diffuse synaptophysin positivity and a Ki-67 index exceeding 60%. GATA3 and p40 were negative. Renal function was confirmed adequate before platinum therapy following palliative TURP(serum creatinine 1.2 mg/dL); etoposide-cisplatin (EP) chemotherapy was administered for six cycles with standard hydration, achieving a marked metabolic response on interim PET/CT. Consolidative pelvic IMRT (55 Gy/20 fractions) followed. Despite this approach, the disease relapsed within 3 months; second-line docetaxel produced no meaningful response. The patient died approximately 11 months from diagnosis. Conclusions:This case underscores the critical importance of recognising the PSA paradox in younger patients with bulky pelvic disease, the indispensable role of a comprehensive IHC panel in confirming the neuroendocrine phenotype and the urgent need for novel therapeutic strategies in this near-universally lethal malignancy.
Despite advances in medical technology, cancer treatment remains challenging. Our research focused on combining microtubule polymerization inhibitors with sonodynamic therapy (SDT) as a promising approach for cancer. SDT is a minimally invasive modality that uses tumor-selective sonosensitizers to induce the death of malignant and tumor-associated cells within the tumor microenvironment through targeted ultrasound irradiation. In this study, verteporfin was selected because of its dual properties of high ultrasound sensitivity and the ability to inhibit the yes-associated protein. Liposome-encapsulated docetaxel and verteporfin were employed to enhance tumor accumulation. This intervention demonstrated remarkable antitumor efficacy in three patients with ovarian metastases from gastric cancer, advanced gastric cancer, and lung metastases from breast cancer, respectively, without notable adverse events. Although the patients with ovarian and lung metastases had experienced progressive disease despite prior chemotherapy and immune checkpoint inhibitor treatment, our intervention successfully inhibited tumor progression. Furthermore, although conventional treatment options were considered unsuitable because of advanced age in the patient with gastric cancer, this intervention demonstrated a favorable safety profile and potential therapeutic benefit. To our knowledge, this study represents the first clinical report demonstrating the potential antitumor efficacy and safety of the combination of verteporfin liposomes, liposomal docetaxel, and SDT.
