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Stage I Uterine Leiomyosarcoma

38-year-old female was diagnosed with stage I uterine leiomyosarcoma with high mitotic count and infiltrative-type growth margins. The expert recommends to give her adjuvant chemotherapy after the surgery - 6 courses of Adriamycin + Ifosfamide chemotherapy and consider radiotherapy afterwards for local control. An alternative treatment is with the combination of Gencitabine + Taxotere. Her prognosis depends on recurrence.

 

Infiltrating Duct Carcinoma of Breast – additional opinion

51-year-old female was diagnosed with stage I, Grade I infiltrating duct carcinoma of the breast. Estrogen receptors were highly positive and Progesterone receptors negative. Based on these findings the expert advises that she receive adjuvant radiotherapy and hormonotherapy. The adjuvant hormonotherapy consist of initial treatment by Tamoxifen for 2 years, thereafter switched to an Aromatase Inhibitor. The expert also informs the patient about potential side effects of Tamoxifen treatment, which are not frequent and generally mild.

Metastatic melanoma stage IIIC

A 58 year-old woman who first presented for evaluation of a bleeding pigmented lesion on the back. An excisional biopsy was performed and revealed a nodular melanoma. A wide excision was performed and no residual melanoma was identified. After a sentinel lymph node biopsy found to be positive, a completion of node dissection was performed and on pathological evaluation, total 6 of 17 lymph nodes contained melanoma.
Staging studies included whole body PET/CT scan and a head CT. FDG uptake by PET was noted in the left axilla only, with no evidence of more distant metastatic disease.

Portosystemic Encephalopathy in Hepatocellular Carcinoma

Adult male with a history of hepatitis C, non-Hodgkin’s lymphoma (NHL) and hepatocellular carcinoma. Patient treated for NHL with CHOP-R 4 years ago. However, post-treatment, he had continued presumed bone marrow suppression. He was diagnosed 2 years later with HCC and underwent TACE with good effect. Since the TACE, the patient has had persistent and worsening hepatic dysfunction with portal hypertension and ascites. Recently, the patient developed encephalopathy and was treated, as described below, with fast return to consciousness.