Metastatic prostate cancer recurrence after definitive local therapy can occur in any tissue. Usually, the first affected site is the bone. Lung metastases without bone or lymph node involvement are extremely rare in patients with prostate cancer, and only a handful of cases are reported in the literature. In several other malignancies, such as breast cancer, sarcomas, colorectal cancer, and renal cell carcinoma, long-term disease-free survival has been reported after resection of solitary pulmonary metastases.We present three unusual cases of isolated pulmonary recurrence of prostate cancer after initial definitive local therapy. One of the patients underwent resection of the lung metastasis, resulting in a long-term disease-free survival.Both surgical excision of solitary and oligometastatic lung secondary lesions and systemic therapy can play an important role in long-term disease control. Surgery should be considered for selected and well-informed patients with pulmonary metastasis after primary localised treatment for prostate cancer.

Clinical experience with cannabis derivatives in patients with multiple sclerosis is accumulating steadily, but there is no current literature about its efficacy for SPS. Because MS and SPS share some neurological symptoms such as spasticity and rigidity, it is thought that THC-CBC can be an option for SPS patient. Our case report suggests that THC-CBD oromucosal spray is an alternative treatment for patients with refractory SPS, and further validation is appropriate.

Background Epidermal growth factor receptor (EGFR) inhibitors, such as panitumumab, are used for the treatment of colorectal carcinoma. These treatments have fewer systemic side effects than traditional chemotherapy, but dermatological adverse effects are significantly more common. Purpose To investigate the cutaneous toxicity of panitumumab in patients who received this treatment during the period from May 2010 to September 2011. Materials and methods Patients were identified using an oncology pharmacy informatics tool (Farmis). Dosage, number of cycles, concomitant treatments and dermatological side effects were listed from the electronic medical records. Treatments for the dermatological reactions, such as topical and systemic antibiotics, antihistamines or steroids, were also recorded. Results 12 patients were given panitumumab from May 2010 to September 2011 (The authors have excluded two patients who only received one dose). 8 patients (83.3%) were in monotherapy with panitumumab. 66.7% were male and average age was 66 years old. Side effects on the skin were described in 10 patients (83.3%). 8 patients (66.7%) presented an acneiform rash and 6 (50%) patients presented pruritus. One patient presented a severe eruption which led to dosage reduction and finally stopping the treatment. The other patients presented mild forms of eruption and pruritus. All the dermatological events appeared after first cycle of panitumumab, except in one patient (after the second cycle). 50% of patients were receiving systemic antihistamines and topical antibiotics, and 3 patients (25%) required systemic antibiotics. Conclusions Our results are similar to the findings in current literature (cutaneous eruptions occur in 30-90% of patients treated with EGFR). These side effects of EGFR inhibitors stigmatise the patient in daily life and is necessary to recognise and treat them.

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Background Case reports of suspected adverse drug reactions (ADRs) are common in the medical literature, but there is a high variation in their characteristics, quality and relevance. Purpose The aim of the study is characterise the publications of adverse drug reactions (ADRs) published as letters to the editor (LE) in four Spanish medical journals. Materials and methods Systematic literature survey was realised. The authors evaluated all case reports of adverse drug reactions published as LE during 2 years (since April 2006 to March 2008) in four Spanish medical journals (Medicina Clínica, Revista Clínica Española, Atención Primaria and Anales de Medicina Interna). Reports were excluded if the event was due to medicinal plants or drug abuse, or if the publication was a cases serie. The evaluation of the cases selected for the study was realised by a group of experts made up of three physicians, a pharmacologist and a pharmacist. Main outcome measures are number of suspected adverse reactions and the following characteristics: therapeutic group of the implied drug, seriousness of the reaction, notification to the pharmacovigilance system, year of commercialisation, and previous knowledge of the reaction. Results A total of 771 LE were reviewed and 93 corresponded to suspected ADRs, 20 cases were excluded and finally The authors evaluated 73 publications corresponding to 79 patients and 97 active principles. About active principles implied:39, 2% were nervous system drugs; 22, 8 were antineoplastic and immunomodulating drugs (18, 6%); and 11, 4% were alimentary tract and metabolism drugs. About the seriousness of the ADRs: 44% were serious; 37% were moderate; 16% were mild; and only two cases (3%) were mortal reactions. Nine LE had been notified to the Spanish pharmacovigilance system, and nine active principles corresponded to a drug of recent commercialisation (less than 5 years from its approval). These new active principles were: telithromycin, erlotinib, ezetimibe (two cases), dutasteride, pioglitazone, tenofovir, inhaled iloprost and pregabalin. Analysing previous knowledge of the reaction: 54, 4% were well-known reactions, 31, 6% were anecdotal events, and 13, 9% were unknown reactions. Conclusions The drugs which are used for treat nervous system pathologies and antineoplastic and immunomodulating drugs are highly associated with ADRs. However it does not represent the real percentage of adverse effects of these groups as the main percentage remains underreported. It is necessary more information about new drugs, and a better collaboration between health professionals and the Spanish pharmacovigilance system.