In this article, we report a 34-year-old man who presented with progressive hip pain and osteolytic bone lesions . Primary workup included Core needle biopsies manifested as osteomyelitis; however as no sign of remission was observed, an open biopsy considered which revealed primary bone lymphoma.

Objectives As a pivotal part of precision therapy, PD‐1/PD‐L1 immunotherapy has been gradually used in head and neck cancer (HNC). We investigated the effect and adverse events of PD‐1/PD‐L1 inhibitors alone or with conventional therapy. Design The groups using PD-1/PD-L1 immunotherapy or combining with conventional therapy were defined as the experimental groups, while the standard of care were the control groups. Cochrane Library, Embase, PubMed, and Web of Science were undertaken to identify literature up to November 20, 2020. Overall survival (OS) and progression-free survival (PFS) were the primary outcome measures. Secondary outcome measures included objective response rate (ORR), disease control rate (DCR), any grade and grade≥3 adverse events (AE). Results Five randomized controlled trials (RCTs) and nine single-arm trials were included in the systematic review. The OS of the experimental groups was better than the control groups (OR = 0.63, 95%CI: 0.49‐0.82, I²=35%, P=0.0004), particularly in patients who smoke current/former or with human papillomavirus negative (HPV-). The experimental groups had longer OS than the control groups in patients with PD-L1 positive (OR = 0.75, 95% CI: 0.65‐0.85, I²=0%, P<0.0001). Patients with HPV positive (HPV+) had more favorable OS than those with HPV- (OR = 0.56, 95%CI:0.44-0.71, I²=39%, P<0.00001). There were statistical differences in AEs (e.g., fatigue, rash, hypothyroidism, etc.) and no statistical differences in PFS, ORR, and DCR. Conclusion PD-1/PD-L1 immunotherapy or combining with conventional therapy can improve the treatment effect and induce fewer adverse events of digestion and blood system, except for hypothyroidism.

All vulvar malignancies comprise only 2% of vulvar lesions, since 98% of vulvar neoplasms are benign. Nodular Fasciitis of the vulva present a diagnostic dilemma due in part to the rare nature of these disorders and similarities malignant soft tissue tumors, so publishing descriptions of these entities are essential

Primary breast osteosarcoma (PBOS) is an extremely rare and poor prognostic malignancy that has not a definitive treatment guideline. Here we presented a successfully treated case of PBOS and provided a comprehensive review of the literature which revealed the divergence of opinions regarding the histogenesis and management of this malignancy.

A 70-year-old woman was diagnosed poorly differentiated hepatocellular carcinoma (HCC), lymphocyte rich. In this case, programmed cell death 1 expression was observed. Immune checkpoint inhibitor treatment may be effective in such cases, although there have been no reports of their use for poorly differentiated HCC, lymphocyte-rich.

Aim: A better knowledge of opioid prescribing patterns would help to identify areas of potential improvement in cancer pain management. This study aimed to identify potential inappropriate use (PIU) of strong opioid analgesics in cancer outpatients in their last year of life. Methods: A retrospective cohort of cancer patients dead between 2011 and 2014 and who were exposed as outpatient to a strong opioid analgesic in the last year of life was identified in the “Echantillon Généraliste de Bénéficiaires” (a 1/97th random sample of the French general population). Prescribing patterns of strong opioids were analyzed and PIU was defined by at least one of these criteria: overlapping prescriptions; contraindicated prescriptions; lack of laxatives; potential drug interactions; prescription in patients hospitalized for opioid-related disorders. Factors associated with PIU were investigated through a multiple logistic regression model. Results: One third of the 2,236 patients (median age 72 years (IQR: 61-82), 44.1% of women) presented a PIU (insufficient laxative prescription (19.6% of patients), insufficient background treatment with transmucosal fentanyl (14.8%), overlapping prescriptions (2.6%)). The rate of PIU significantly decreased from 37.6% (2011) to 29.8% (2014). For patients with a duration of opioid use  3 months, factors associated with PIU were fentanyl prescription (aOR=2.36; 95% CI [1.86-3.00]) and previous use of strong opioid (aOR=1.88; [1.50-2.36]) Conclusion: In France, one third of cancer patients exposed to strong opioids experienced PIU and this proportion tended to decrease over time. There is still room for progress in cancer pain management at the end of life.

Splenosis is a condition that occurs after splenic rupture. A 29 year-old male patient with a history of splenectomy, was admitted due to multiple vomiting episodes. The diagnostic workup was unable to differentiate between gastric GIST and splenosis. Laparoscopic surgical resection was performed leading to the diagnosis of splenosis.

Gastric cancer was diagnosed with dilation of the main pancreatic duct. SPACE revealed adenocarcinoma, total gastrectomy with distal pancreatectomy were underwent. More case reports are needed to determine whether adjuvant chemotherapy is indicated for patients with PCIS and whether the extent of lymph node dissection can be safely reduced.

We have used low-dose prednisone, in conjunction with granulocyte, colony-stimulating factor (G-CSF) and erythropoietin, to treat an elderly patient with myelodysplastic syndrome (MDS) with an excess of blasts. Our findings indicate that such treatment is safe and may be effective in the long term survival of patients with high-risk MDS.

Most of the bone metastasis origination from Follicular Thyroid Carcinoma (FTC) will present as non-solitary and non-isolated. We present an extremely unique case of an isolated and solitary lesion in an unusual site, scapula, originated from FTC presenting incredibly about ten years after the initial successful treatment.

Key Points • Transnasal Oesophagoscopy (TNO) is an approach to inspect the upper aerodigestive tract, especially in the head and neck cancer (HNCA) population that present with dysphagia. • Twenty-five (25) office-based TNO procedures were performed, with a same-day discharge rate of 96% (24/25) and no reported complications. • This case series is the first to compare preoperative and postoperative outcomes (EAT-10) following stricture dilatation using TNO in the UK. Our results show a statistically significant improvement in symptom severity (EAT-10 scores) (n=11, P=0.001). In the majority of these patients, strictures were due to post-radiation complications. Biopsy in 4/5 cases was sufficient for diagnosis/ruling out disease. Of these patients, 80% had a previous HNCA. • This study identifies the remit for a new ‘one-stop’ TNO service for suspected cancer referrals, of which a large proportion are patients with a previous HNCA. Surveillance, therapeutics and diagnostics can be achieved in a single visit. • Earlier staging or treatment may be achieved due to a fast turnover in clinic

Objectives To evaluate the benefits imparted by concurrent chemoradiotherapy (CCRT) and chemotherapy of any form to elderly head and neck cancer (HNC) patients in Ireland. Secondary outcomes included comparison of these benefits to the adult population and subgroup analysis by site. Design, setting, and participants A retrospective cohort study was conducted using 20 years of cancer registry data provided by the National Cancer Registry of Ireland. All HNC diagnosed from 1994-2014 were included. Cox multivariate regression analysis was applied to test for the benefits of CCRT and chemotherapy of any form in HNC. The primary outcome measures were cancer-specific and all-cause survival in months. Results Survival analysis showed an overall benefit to the use of CCRT in patients with advanced disease over 65 years, particularly when used for hypopharyngeal, oral cavity, oropharyngeal, and laryngeal malignancy, though the latter did not achieve statistical significance. Chemotherapy of any form conferred a survival benefit in elderly patients with hypopharyngeal, laryngeal, nasopharyngeal, and oropharyngeal cancer. Conclusion CCRT and chemotherapy of any form confer significant survival benefits to appropriately selected elderly HNC patients and should therefore not be withheld solely on the basis of age.

Three years old boy presented with recurrent severe abdominal pain. He was treated for constipation and the pain resolved. Later he developed a limitation of neck movements. Investigations revealed a spinal cord mass. After surgical resection, histopathology confirmed pilocytic astrocytoma.

T-cell large granular lymphocytic leukemia (T-LGL) is a chronic malignancy characterized by clonal expansion of cytotoxic T-cells possibly complicated by cytopenias of one or more myeloid lineages. By describing a multiply-refractory T-LGL case, this report highlights the importance of molecular-targeted and non-cytotoxic therapies in the context of frail elderly patients.

Gastric cancer rarely disseminates to the bone. Initial clinical presentation of bone metastasis without any preceding gastrointestinal symptoms in gastric cancer patient is also extremely infrequent. Herein, we report an original case of gastric cancer revealed by a pathologic fracture due to bone metastasis.

A document by Tomoaki Takada, written on Authorea.

We encountered a case in which a recurrent condyloma-like papillary tumor was repeatedly treated as condyloma. Therefore, the patient was re-diagnosed and treated for non-invasive cervical papillary squamous cancer (PSCC) with HPV6 infection. To the best of our knowledge, this is the first report of HPV6 infection in PSCC.

The sternum is an exceptional localization for Diffuse Large B Cells Lymphoma. A Case of a man with a sternal mass that mimics a sarcoma on the CT scan. Needle biopsy was not contributive. Surgical resection was indicated because of a local progression. Histopathological examination concluded to a primary DLBCL

Large cell neuroendocrine carcinoma (LCNEC) was first proposed by Travis et al. in 1991 and subsequently classified as high grade neuroendocrine carcinoma (HGNEC) by the world health organization. It is a rare tumor with unclear clinicopathologic features. Herein, we describe a rare case of LCNEC with a unique Cushing’s presentation.

Pediatric chronic myeloid leukemia is a rare entity (2-5% of childhood leukemias) classified as a myeloproliferative neoplasia characterized by the presence of the BCR-ABL fusion gene, the oncogenic translocation product (9; 22) responsible for the disease through its deregulated tyrosine kinase activity.

The choice of patient for a single lung resection is challenging for the surgeon. This report is presenting our experience in surgical treatment for patient with metastatic synovial sarcoma who initially underwent total left pneumonectomy and to identify possible predictors for the selection of patients who may undergo surgical treatment.

Lentigines are brown macules which represent increased proliferation of melanocytes at the dermo-epidermal junction. We report three cases of acral lentiginosis in children following chemotherapy for acute lymphoblastic leukaemia (ALL) which have persisted following cessation of chemotherapy, despite avid photoprotection.

Those patients with hypopharyngoesophageal cancer often sacrificed larynx before reconstruction using jejunum to restore the continuity of the digestive tract and allow oral alimentation. We retrospectively collected and analyzed three patients who underwent hypopharyngoesophageal reconstruction by free partial patch and partial tube jejunal graft transfer with reservation of laryngeal function caused by hypopharyngeal cancer invading the cervical esophagus. The partial patch and partial tube jejunal graft transfer survival rate was 100%(3/3). The larynx was reserved in the three patients. The partial patch and partial tube jejunal graft transfer is a safe and reliable choice for reconstruction of large and complex defects after pharyngectomy and cervical esophagectomy with larynx preserved.

Key Points: 1. We have identified ambiguity in the current guidance on thyroid MDT’s, and have also found nationwide variation in compliance with this. 2. We recommend: a. All surgeons undertaking thyroid surgery should complete a minimum of 20 thyroid procedures per year, and this should also form part of surgeons’ annual appraisal. b. All surgeons should contribute data to UKRETS (unless prevented by local legal frameworks) and this should form part of surgeons’ annual appraisal and be audited by individual MDT’s and regional cancer networks. c. Thyroid MDT’s should be held weekly where possible, with a minimum frequency of fortnightly. d. The core membership of a thyroid MDT (stand alone and joint) should include thyroid surgeons, specialist radiology, endocrinology, nuclear medicine, nurse specialists, histopathology +/- cytology and clinical oncology.