A rare case of extremely delayed osseous metastasis of pineoblastoma

Pineoblastoma is a rare, primitive, and malignant tumor arising from the parenchyma of the pineal gland. It typically metastasizes along the cerebral neural axis, with rare extraneural metastasis and even more rare intraosseous extraneural metastasis. A patient with pineoblastoma, initially treated with chemotherapy, presented 10 years after initial diagnosis with multiple osseous metastases including his pelvis, femur, and vertebrae, and is currently undergoing chemotherapy.

Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Presenting as Suspected Cervical Osseous Metastasis : A Case Report and Literature Review

Background : The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is an uncommon variant of PTC. Although its histologic features are aggressive, its prognostic significance remains controversial. Case summary : Bone scan of 41-year-old woman with a history of breast and thyroid cancers showed suspected cervical osseous metastasis during the previous cancer follow-up. Further, magnetic resonance imaging was recommended. Preoperative fine needle aspiration cytology showed features of thyroid papillary carcinoma and postoperatively, the mass was diagnosed to DSV-PTC showing features of numerous and diffuse calcification and squamous metaplasia. Conclusion : Herein, we describe the pathologic features, including histologic and fine-needle aspiration cytologic features, and prognostic implications through a literature review.

Bilateral Exudative Retinal Detachments Associated with Nivolumab Immunotherapy

A 58-year-old Caucasian female presented to the retina service with a 2-week history of bilateral decrease in vision. She had stage 4 renal cell carcinoma with osseous metastasis and choroidal metastasis for which she has been treated with Nivolumab immunotherapy. Her exudative retinal detachments resolved after cessation of Nivolumab in association with subtenon steroids (STK) and intravitreal bevacizumab injections. To the best of our knowledge, this is the first report in the literature describing the resolution of Nivolumab-related exudative retinal detachment after early local therapy using STK injections (10 mg), bevacizumab intravitreal injections, and cessation of Nivolumab. We hope by sharing this report to provide new insight into the management of similar patients.

Uterine Carcinosarcoma: A Case Report and Literature Review

Uterine carcinosarcomas are rare and extremely aggressive undifferentiated carcinomas which include both carcinomatous and sarcomatous elements. A 52-year-old female presented with heavy irregular menstrual bleeding for several years and new right elbow pain and swelling. Ultrasound and computed tomography showed a large uterine mass with regional and distant metastatic lymphadenopathy and suspicious findings of osseous metastasis to the right elbow. A biopsy confirmed uterine carcinosarcoma, and the patient underwent chemotherapy and then surgical resection of the uterine mass with palliative radiotherapy of the right elbow. The postoperative imaging showed new metastasis, and the patient was scheduled to start on immunotherapy. Considering the highly invasive nature of uterine carcinosarcomas, timely detection of this cancer using characteristic imaging and pathology findings is of extreme importance to improve the patient’s survival.