To Treat or Not to Treat Poorly Differentiated Adenocarcinoma of Unknown Origin

Abstract

This case illustrates that although advances have been made with diagnosis and treatment of adenocarcinoma of unknown origin with targeted therapy, more research needs to be done on poorly differentiated adenocarcinoma that initially presents with extensive metastases. In this patient’s case, it was beneficial and ethical to reduce the toxicity and emotional burden and thus limit further investigation into her adenocarcinoma. However, it is imperative to recognize that only a small subset of adenocarcinoma of unknown origin are responsive to current therapies and more research is required for the many cases that present with poorly differentiated adenocarcinoma and widespread metastasis.

Refractory Hypokalemia in Secretory Diarrhea Phenotype of Colonic Pseudo-Obstruction (Ogilvie's Syndrome)

“…The first case to use spironolactone as part of the treatment of hypokalemia associated with SD-CPO was by Ram et al in 2016 [7]. Subsequent case reports reported significant improvement in hypokalemia after the initiation of spironolactone [3,10,11]. Similarly, Somatostatin and its analog inhibit BK channels [12], leading to the improvement of hypokalemia in a patient with SD-CPO [13].…”

“…Consequently, it halts the process of colonic dilatation and prevents its recurrence [15]. It has been reported that hypokalemia can improve after the initiation of Neostigmine in patients with colonic pseudoobstruction [10]. Lastly, surgical interventions can be used as the last resort if conservative, pharmacological, and colonoscopic therapies are ineffective.…”