The Bayesian estimation presented in this study was an easy and convenient method to efficiently detect patients with impaired MTX elimination in routine clinical practice. This information enabled the introduction of strategies for minimizing the risk of severe drug toxicity.

To cite this version:Frederic Ternier. Sonographic appearance of a metastasis to the breast from a cerebellar medulloblastoma. Journal of Clinical Ultrasound, Wiley, 2010, <10.1002/jcu.20698>. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 AbstractWe present the case of a 29 year old 29-year-old woman with a medulloblastoma of the cerebellum who developed a breast mass during the course of her disease. Core biopsy of the breast lesion revealed a metastatic medulloblastoma. Development of metastasis to the breast from medulloblastoma is very rare and the prognosis for such patients is poor. It is important to distinguish a primary breast cancer from metastasis to the breast, as both since the therapeutic options as well as the prognosis are very different. To our knowledge, it is the first report of the sonographic appearance of a medulloblastoma metastasic to the breast diagnosed by corebiopsy. Page 2 of 19John Wiley & Sons 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 Medulloblastoma is a highly malignant tumor of the cerebellum that has a strong propensity to disseminate along the cerebrospinal pathways. Medulloblastoma is primarily a tumor seen in children and teenagers and which is particularly rare in adults. Standard treatment consists of complete excision of the tumor followed by radiation to the entire craniospinal axis with a boost to the primary tumor site. The role of adjuvant chemotherapy in adults is controversial. Journal of Clinical UltrasoundRelapse is most commonly within the posterior fossa and systemic metastases are rare. 1Extraneural metastases most commonly involve bone and bone marrow, followed by lymph nodes. 1,2 Although even less common, metastases to the breast have been reported in adults. [2][3][4][5][6] We report an extremely rare occurrence of metastatic medulloblastoma to the breast, describing its sonographic appearance and its diagnosis using ultrasound-guided core biopsy. Case reportA 29 year old 29-year-old woman was referred to our institution for percutaneous biopsy of a palpable mass in her right breast. She had a history of médulloblastoma medulloblastoma of the cerebellum treated by complete surgical exeresis resection without the need for a shunt and radiotherapy ventricular shunt, followed by craniospinal radiotherapy, in another hospital, 5 years previously. Secondary Secondarily, 3 years after the excision of the médulloblastoma medulloblastoma, she developed a bicytopenia (Hemoglobin 7,4 g/dL, platelets 34 x 10³ /L).A bone scan revealed diffuse osteoblastic desease disease. Bone marrow aspirate was positive for medulloblastoma cells. Nine cycles of carboplatin and etoposid were administred after w...

We report the case of a patient bearing a T315I-mutant chronic myeloid leukemia resistant to nilotinib, successfully treated with omacetaxine and then with dasatinib. After 9 months of nilotinib, the patient achieved a major molecular response but relapsed 3 months later due to the T315I mutation. Because third-generation tyrosine kinase inhibitor was not available and the patient refused bone marrow transplantation, he received two cycles of omacetaxine. This treatment had been stopped after two cycles because of clinical intolerance, but a major molecular response and total disappearance of the T315I clone was obtained. Treatment with dasatinib was then started and after 34-month follow-up the patient is still in major molecular response, thus suggesting that eradication of the T315I mutation could be achieved without third-generation tyrosine kinase inhibitors.