This cross-sectional study evaluated the genetic landscape of a cohort of patients with metastatic prostate cancer who were treated at a referral center in Mexico City, Mexico.
We describe a unique clinical case of primary melanoma of the ascending colon presenting with intussusception and profuse hemorrhage. A 72-year-old man on anticoagulant therapy was admitted with massive rectal bleeding and hypotension. Colonoscopy revealed an 8-cm obstructing exophytic tumor. CT scan confirmed enteroenteric intussusception via the pathognomonic pseudokidney sign. Diagnosis was established by immunohistochemical analysis, demonstrating positive expression of S100 protein and melanoma-associated antigens, while negative for melanocyte antigen A and BRAF mutations. The patient underwent emergency right-sided hemicolectomy with lymphadenectomy. Pathomorphological evaluation confirmed stage T4aN0M0 (R0 resection). Following an accelerated recovery protocol, the patient started adjuvant immunotherapy with PD-1 inhibitors. This case underscores the need for a multidisciplinary approach and extended immunohistochemical profiling to diagnose rare mucosal pathologies. It highlights the effectiveness of radical surgery combined with modern systemic immunotherapy in emergency settings. Given the aggressive nature of mucosal melanoma, adhering to oncological guidelines and considering early immunotherapy are crucial for optimizing clinical outcomes.
Adult T-cell leukemia/lymphoma (ATLL) is an aggressive lymphoma with a poor prognosis. The human T-lymphotropic virus 1 (HTLV-1) is associated with immunodeficiency and increased extranodal involvement in patients with diffuse large B-cell lymphoma (DLBCL). We report on a 47-year-old woman with spastic paraparesis and hepatitis B who was diagnosed with the acute form of ATLL. The clinical picture reveals peripheral generalized lymphadenopathy and splenomegaly. Findings on a hematologic exam indicated leukocytosis with lymphocytosis. A bone marrow biopsy/aspiration confirmed 50% T-cell lymphoid infiltration. Biochemistry results revealed hypercalcemia and a high lactate dehydrogenase value. Results of a CT scan indicated abdominal and thoracic adenopathy as well as moderate splenomegaly. A supraclavicular lymph node biopsy established a DLBCL diagnosis. The final diagnosis was composite lymphoma, DLBCL, and ATLL. The CHOP (cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate [Oncovin], and prednisone) regimen was chosen due to the patient's ECOG performance status. Multiple infectious complications were diagnosed during chemotherapy-induced secondary aplasia. A complete remission, confirmed via PET-CT imaging, was obtained. After 1 month, a skin tumor on the upper right thigh was discovered and biopsied, and the histopathological exam and immunochemistry findings indicated Epstein-Barr virus-DLBCL lymphoma. The association of 2 aggressive lymphomas in a single HTLV-1 carrier is a rare report, and the evolution was severe, complicated by opportunistic infections, and unfavorable.
BACKGROUND:Breast cancer is the most prevalent malignancy among women and frequently causes significant psychological distress, such as anxiety and depression. The perception and impact of social support in addressing these mental health challenges differ depending on cultural and societal factors, highlighting its crucial role. AIM:This study aimed to evaluate the association between anxiety and depression in Palestinian women with breast cancer and perceived social support (PSS). METHODS:A descriptive, cross-sectional design was employed. The study included 257 patients with breast cancer. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. PSS was measured using the Medical Outcomes Study Social Support Survey. RESULTS:Most participants (95%) were married. The mean age was 51 ± 9.8 years. The total PSS was relatively mild to moderate (M = 69.7 ± 9.5). The scores for anxiety and depression were in the borderline range(M = 7.8 ± 3.3 and M = 8.3 ± 3.6, respectively). All subclasses of PSS were negatively correlated with anxiety and depression ( P < .05). CONCLUSION:Every individual has a unique perception of social support. Depression and anxiety affect a sizable percentage of patients with breast cancer. Higher levels of social support may also assist in reducing depression and anxiety, as seen by the strong negative association found between these psychological states and PSS.
BACKGROUND:Patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICIs), alone or in combination with tyrosine kinase inhibitors (TKIs), often experience significant treatment-related adverse events, including fatigue, that can impair health-related quality of life (HRQOL). Structured exercise interventions may mitigate these symptoms, but data in mRCC are limited. OBJECTIVE:To evaluate the feasibility and impact of a 12-week supervised remote exercise program on HRQOL, fatigue, and symptom burden in patients with mRCC receiving ICIs or ICI-TKI combinations. METHODS:Nineteen patients with mRCC (median age 67 years; 57.9% male) participated in a 12-week home-based exercise program, supervised via telehealth. The program included aerobic, resistance, and mobility exercises delivered through weekly virtual consultations and supported by the Vedius platform. Outcomes were assessed at baseline and post intervention using the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator (FACT-ICM), Brief Fatigue Inventory (BFI), and Edmonton Symptom Assessment System (ESAS). RESULTS:Participants demonstrated significant improvements in overall HRQOL (FACT-General mean increase, 9.8 points; P = .001; Cohen d = 0.8), treatment-related toxicity (ICM mean increase, 10.1 points; P = .017), and fatigue (BFI mean decrease, 21.1 points; P = .018; ESAS fatigue mean decrease, 5.0 points; P = .001; Cohen d = -1.5). Symptom burden (ESAS mean decrease, 12.3; P = .001) and key patient-reported outcomes, including anxiety, depression, appetite loss, and sleep disturbances, also improved ( P ≤ .02). CONCLUSIONS:A 12-week supervised remote exercise program was feasible and associated with meaningful improvements in HRQOL, fatigue, and symptom burden among patients with mRCC undergoing ICI-based therapies. These findings support the integration of structured exercise into supportive care for mRCC, highlighting the potential of remote interventions to enhance physical and emotional well-being. Future studies should confirm these results in larger randomized trials and identify the most effective program components.
