Adult intussusception is an infrequent occurrence typically resulting from an identifiable lead point of a benign or malignant etiology. Here, we present a case of a 19-year-old male who presented to the emergency department with complaints of abdominal pain, intractable nausea, and fluctuations between bloody diarrhea and constipation. These symptoms had begun two months prior and had increased in severity, resulting in significant appetite changes. An abdominal and pelvic computed tomography scan without contrast was obtained, which showed evidence of intussusception of the ileocecum into the transverse colon with resultant small bowel obstruction. The patient underwent an exploratory laparotomy, which resulted in a partial ileocolectomy due to the presence of a 6.8 cm cecal mass with palpable mesenteric lymphadenopathy. The pathologic specimen was identified as Burkitt lymphoma based on a combination of histologic, immunohistochemical, and fluorescence in situ hybridization findings. Currently, the patient is undergoing three cycles of rituximab, cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate, ifosfamide, etoposide, and high-dose cytarabine (R-CODOX-M/IVAC) per Magrath protocol for low-risk Burkitt lymphoma.

26 Nov 2023·Journal of Clinical and Experimental Hematopathology

Methotrexate-induced subacute myelopathy: a serious but treatable complication

Article

Author: Kobayashi, Katsuya ; Kondo, Tadakazu ; Yoshinaga, Noriyoshi ; Takaori-Kondo, Akifumi ; Oka, Satoshi ; Fujimoto, Masakazu ; Nishikori, Momoko ; Asagoe, Kohsuke ; Kitawaki, Toshio ; Imashuku, Shinsaku ; Miyoshi, Takashi

Subacute myelopathy is a rare but serious complication of methotrexate (MTX) that may cause paraplegia. Although its underlying mechanisms have not been fully elucidated, homocysteine is thought to play a role in the pathogenesis of this adverse effect. Herein, we report the case of a 34-years old female patient with diffuse large B-cell lymphoma who developed progressive paraplegia accompanied by dysfunctional bladder and bowel movements after treatment with a modified CODOX-M/IVAC regimen, including high-dose intravenous MTX and intrathecal (IT-) MTX. Neurological symptoms gradually improved to almost normal levels within 4.5 months of onset following treatment with a combination of S-adenosylmethionine, methionine, cyanocobalamin, and folate. During chemotherapy, including high-dose MTX and IT-MTX for hematological malignancies, MTX-induced subacute neuronal damage should be carefully evaluated, and appropriate treatment should be initiated as early as possible.

01 Oct 2023·Clinical Case Reports

A rare case of Burkitt's lymphoma of the breast in a 19‐year‐old male: Case report

Author: Solomon, Kibudde ; Kato, Ronald

Key Clinical MessageBurkitt's lymphoma is a highly aggressive non‐Hodgkin's lymphoma that can affect various parts of the body, which include jaw, facial bones, retroperitoneum, and abdominal viscera, it is worth noting that breast involvement is extremely rare in Burkitt's lymphoma and has not been documented.AbstractBurkitt's lymphoma is a highly aggressive non‐Hodgkin's lymphoma that can affect various parts of the body including breast. This sarcoma is identified as a rapidly fatal malignant lymphoma syndrome and 50% of all malignant tumors in children. However, breast involvement has not been documented. A 19‐year‐old male presented to our emergency department with a left breast swelling for 2 months associated with drenching night sweats, weight loss and evening fevers. Physical examination revealed a mass measuring approximately 15 × 16 × 15 cm in the widest dimension, skin hyperpigmentation, no nipple discolorations, discharges, and non‐tender on palpation. Biopsy was done, and the histology report revealed sheets of monomorphic medium lymphocytes with a high mitotic rate and frequent apoptotic bodies showing a starry‐sky appearance. The immunohistochemistry report revealed positive staining for Ki‐67, CD‐20, and CD‐10 tumor markers and CD45 on flow cytometry. The patient was started on aggressive hydration, rasubricase administration, CODOX‐M/IVAC regimen 6 cycles, and G‐CSF and registered significant reduction in the size of the mass. Burkitt's lymphoma is a highly aggressive non‐Hodgkin's lymphoma that can affect various parts of the body. It commonly involves the jaw, facial bones, retroperitoneum, and abdominal viscera. The disease typically affects young patients in areas of high incidence, such as the jaw, whereas visceral involvement is more common in older patients in low‐incidence areas. It is worth noting that breast involvement is extremely rare in Burkitt's lymphoma.

100 Deals associated with IVAC M uID

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Indication	Highest Phase	Country/Location	Organization	Date
Breast Cancer	Phase 1	-	BioNTech SE	-
Breast Cancer	Phase 1	-	TRON Inc.	-

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


ASCO2012	Phase 2	Burkitt Lymphoma	25	CODOX-M/IVAC	(rfkkerthtc) = nfphgoqfsv ssyfgiouzr (rkzaxmfjgq ) View more	-	20 May 2012

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