A 67-year-old female taking Nivolumab for melanoma developed a hyperglycemic emergency requiring hospital admission. She was referred to our endocrinology clinic post-discharge where she was diagnosed with new-onset Type 1 diabetes mellitus. Severe hyperglycemia and immune-mediated diabetes mellitus are extremely rare but potentially life-threatening side effects of Nivolumab.

A 52-year-old female presented to our hospital with an acute history of isolated bilateral arm weakness. An MRI of the cervical spine confirmed an acute anterior spinal artery infarction. Further investigations to determine a specific etiology were unremarkable, leading to a diagnosis of idiopathic anterior spinal artery infarction consistent with Man-in-the-Barrel syndrome.

No abstract

Primary signet-ring cell adenocarcinomas (SRCA) that occur outside the gastrointestinal tract are rare with few cases reported in the literature. They carry a poor prognosis and can be a challenge to diagnose. In this case report, we present the case of a 69-year-old female who presented to our hospital with a large left-sided pleural effusion. The findings seen on histopathology and immunohistochemistry (IHC) staining of the pleural fluid were consistent with primary signet-ring cell adenocarcinoma of the lung, and further investigations excluded a secondary source of malignancy. To the best of our knowledge, this is the first reported case of pleural effusion without an underlying lung mass diagnosed as primary signet-ring cell adenocarcinoma of the lung. Given how rare primary signet-ring cell adenocarcinoma of the lung is, it is important for physicians to carry out a comprehensive diagnostic workup to differentiate between primary and metastatic signet-ring cell adenocarcinoma as this will determine prognosis and treatment.