Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
Cited by 1 publication
References 22 publications
Lack of efficacy and rapid progression of pre-existing undifferentiated multi-metastatic carcinoma: case reportA 69-year-old man exhibited lack of efficacy following treatment with methotrexate, rituximab and unspecified tumour necrosis factor inhibitor for rheumatoid arthritis (RA). Additionally, he experienced rapid progression of pre-existing undifferentiated multimetastatic carcinoma following treatment with methotrexate, rituximab and abatacept for RA [routes, dosages and durations of treatments to reactions onsets not stated].The man presented for further evaluation of his progressive polyarthralgia. His medical history was significant for colorectal cancer, a chronic multi-operated eventration, several occlusive syndrome on a flange, chronic post-smoking bronchitis and obliterating arteriopathy of the lower limbs. Following further investigation, he was diagnosed with seropositive RA. Due to atypical course of disease, a paraneoplastic origin was suspected. CT scan showed significant bilateral emphysematous lesions in the chest but no suspicious nodular image. A hepatic lesion of 22 mm was noted in the dome in the abdomen. A liver biopsy suggested steatotic focal nodular hyperplasia. He started receiving unspecified corticosteroid therapy along with successive therapies with methotrexate, unspecified tumour necrosis factor inhibitor [anti-TNF] and then rituximab for the management of RA. However, methotrexate, rituximab and unspecified tumour necrosis factor inhibitor therapy were ineffective. In September 2019, he started receiving abatacept injection with rapid remission of RA. His corticosteroid therapy was discontinued. In October 2019, due to an occlusive syndrome on a flange, an abdominal CT scan was performed which showed no suspicious lesions. In November 2019, following the fourth injection of abatacept, he was hospitalised due to debilitating low back pain. He was found to have a significant biological inflammatory syndrome with CRP of 214 mg/L. Subsequent abdominal CT showed a liver lesion of 2cm. Spinal MRI showed multiple secondary bone lesions, disseminated to the entire thoracic and lumbar cervical spine. PET-CT scan performed 2 weeks later revealed a right upper lobe hypermetabolic pulmonary mass as well as pleural, pulmonary, mediastinal, bilateral adrenal, hepatic, peritoneal, muscular and lytic bone metastases. Bone marrow biopsy revealed medullary infiltration by malignant tumour proliferation of an undifferentiated carcinoma. The immunohistochemical study remained negative for all the markers used. Hence, primary origin of carcinoma could not be identified. His general condition deteriorated rapidly leading to death within a few days. The abatacept therapy was considered to have led to rapid progression of pre-existing undifferentiated multi-metastatic carcinoma. Methotrexate and rituximab were also suspected to have contributed in the rapid progression of pre-existing undifferentiated multi-metastatic carcinoma. The possible association between the rapid progression of carcinoma and a...
Lack of efficacy and rapid progression of pre-existing undifferentiated multi-metastatic carcinoma: case reportA 69-year-old man exhibited lack of efficacy following treatment with methotrexate, rituximab and unspecified tumour necrosis factor inhibitor for rheumatoid arthritis (RA). Additionally, he experienced rapid progression of pre-existing undifferentiated multimetastatic carcinoma following treatment with methotrexate, rituximab and abatacept for RA [routes, dosages and durations of treatments to reactions onsets not stated].The man presented for further evaluation of his progressive polyarthralgia. His medical history was significant for colorectal cancer, a chronic multi-operated eventration, several occlusive syndrome on a flange, chronic post-smoking bronchitis and obliterating arteriopathy of the lower limbs. Following further investigation, he was diagnosed with seropositive RA. Due to atypical course of disease, a paraneoplastic origin was suspected. CT scan showed significant bilateral emphysematous lesions in the chest but no suspicious nodular image. A hepatic lesion of 22 mm was noted in the dome in the abdomen. A liver biopsy suggested steatotic focal nodular hyperplasia. He started receiving unspecified corticosteroid therapy along with successive therapies with methotrexate, unspecified tumour necrosis factor inhibitor [anti-TNF] and then rituximab for the management of RA. However, methotrexate, rituximab and unspecified tumour necrosis factor inhibitor therapy were ineffective. In September 2019, he started receiving abatacept injection with rapid remission of RA. His corticosteroid therapy was discontinued. In October 2019, due to an occlusive syndrome on a flange, an abdominal CT scan was performed which showed no suspicious lesions. In November 2019, following the fourth injection of abatacept, he was hospitalised due to debilitating low back pain. He was found to have a significant biological inflammatory syndrome with CRP of 214 mg/L. Subsequent abdominal CT showed a liver lesion of 2cm. Spinal MRI showed multiple secondary bone lesions, disseminated to the entire thoracic and lumbar cervical spine. PET-CT scan performed 2 weeks later revealed a right upper lobe hypermetabolic pulmonary mass as well as pleural, pulmonary, mediastinal, bilateral adrenal, hepatic, peritoneal, muscular and lytic bone metastases. Bone marrow biopsy revealed medullary infiltration by malignant tumour proliferation of an undifferentiated carcinoma. The immunohistochemical study remained negative for all the markers used. Hence, primary origin of carcinoma could not be identified. His general condition deteriorated rapidly leading to death within a few days. The abatacept therapy was considered to have led to rapid progression of pre-existing undifferentiated multi-metastatic carcinoma. Methotrexate and rituximab were also suspected to have contributed in the rapid progression of pre-existing undifferentiated multi-metastatic carcinoma. The possible association between the rapid progression of carcinoma and a...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
Contact Info
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Product
Resources
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.
