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  1. Article ; Online: Stereotactic body radiation therapy for an unresectable FGF23-secreting tumor of the cervical spine: A case report and literature review.

    Hockemeyer, Kathryn / Purswani, Juhi M / Kim, Joseph K / Givi, Babak / Zan, Elcin / Pacione, Donato / Shapiro, Maksim / Laufer, Ilya / Feffer, Jill B / Silverman, Joshua S

    Journal of radiosurgery and SBRT

    2023  Volume 8, Issue 4, Page(s) 321–324

    Abstract: We present the case of a 65-year-old male with tumor-induced osteomalacia (TIO) caused by an FGF23-secreting phosphaturic tumor of C2 treated definitively with stereotactic body radiation therapy (SBRT) and kyphoplasty. The patient exhibited notable ... ...

    Abstract We present the case of a 65-year-old male with tumor-induced osteomalacia (TIO) caused by an FGF23-secreting phosphaturic tumor of C2 treated definitively with stereotactic body radiation therapy (SBRT) and kyphoplasty. The patient exhibited notable reduction in FGF23 6 weeks following radiotherapy. He also received a dose of the FGF23 monoclonal antibody, burosumab. We discuss the case with emphasis on radiation in the management of TIO. This case demonstrates SBRT as a well-tolerated local treatment option for the management of unresectable FGF23-producing tumors.
    Language English
    Publishing date 2023-06-28
    Publishing country United States
    Document type Journal Article
    ISSN 2156-4647
    ISSN (online) 2156-4647
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Dual Paraneoplastic Endocrine Syndromes Heralding Onset of Extrapulmonary Small Cell Carcinoma: A Case Report and Narrative Review.

    Feffer, Jill B / Branis, Natalia M / Albu, Jeanine B

    Frontiers in endocrinology

    2018  Volume 9, Page(s) 170

    Abstract: Objective: Extrapulmonary small cell carcinoma (EPSCC) is rare and frequent metastases at presentation can complicate efforts to identify a site of origin. In particular, SCC comprises <1% of prostate cancers and has been implicated in castration ... ...

    Abstract Objective: Extrapulmonary small cell carcinoma (EPSCC) is rare and frequent metastases at presentation can complicate efforts to identify a site of origin. In particular, SCC comprises <1% of prostate cancers and has been implicated in castration resistance.
    Methods: Clinical, laboratory, imaging, and pathology data are presented.
    Results: A 56-year-old man with locally advanced prostate adenocarcinoma on androgen deprivation therapy presented with a clogged nephrostomy tube. Laboratory results included calcium 13.8 mg/dL (8.5-10.5 mg/dL), albumin 3.6 g/dL (3.5-5 mg/dL), and potassium 2.8 mmol/L (3.5-5.2 mmol/L). Hypercalcemia investigation revealed intact PTH 19 pg/mL (16-87 pg/mL), 25-OH vitamin D 15.7 ng/mL (>30 ng/mL), and PTH-related peptide (PTHrP) 63.4 pmol/L (<2.3 pmol/L). Workup for hypokalemia yielded aldosterone 5.3 ng/dL (<31 ng/dL), renin 0.6 ng/mL/h (0.5-4 ng/mL/h), and 6:00 a.m. cortisol 82 µg/dL (6.7-22.6 µg/dL) with ACTH 147 pg/mL (no ref. range). High-dose Dexamethasone suppression testing suggested ACTH-dependent ectopic hypercortisolism. Contrast-enhanced CT findings included masses in the liver and right renal pelvis, a heterogeneous enlarged mass in the region of the prostate invading the bladder, bilateral adrenal thickening, and lytic lesions in the pelvis and spine. Liver biopsy identified epithelioid malignancy with Ki proliferation index 98% and immunohistochemical staining positive for synaptophysin and neuron-specific enolase, compatible with high-grade small cell carcinoma. Staining for ACTH was negative; no stain for CRH was available. Two weeks after chemotherapy, 6:00 a.m. cortisol normalized and CT scans showed universal improvement.
    Conclusion: Extensive literature details paraneoplastic syndromes associated with SCC, but we report the first case of EPSCC diagnosed due to onset of dual paraneoplastic syndromes.
    Language English
    Publishing date 2018-04-18
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2018.00170
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Parenchymal splenic metastasis is an independent negative predictor of overall survival in advanced ovarian, fallopian tube, and primary peritoneal cancer.

    Tanner, Edward J / Long, Kara C / Feffer, Jill B / Leitao, Mario M / Abu-Rustum, Nadeem R / Barakat, Richard R / Chi, Dennis S / Gardner, Ginger J

    Gynecologic oncology

    2013  Volume 128, Issue 1, Page(s) 28–33

    Abstract: Objective: The purpose of this study was to evaluate the significance of parenchymal splenic metastasis (PSM) in ovarian (OC), fallopian tube (FTC), and primary peritoneal cancer (PPC).: Methods: All patients with stage IIIB-IV OC, FTC, and PPC ... ...

    Abstract Objective: The purpose of this study was to evaluate the significance of parenchymal splenic metastasis (PSM) in ovarian (OC), fallopian tube (FTC), and primary peritoneal cancer (PPC).
    Methods: All patients with stage IIIB-IV OC, FTC, and PPC undergoing primary cytoreduction from 2001 to 2010 at our institution were identified. In patients undergoing splenectomy, pathology was reviewed for the presence of PSM. Multivariate Cox regression and Kaplan-Meier survival analysis were used to evaluate factors associated with overall survival (OS).
    Results: Of 576 patients identified, stage was: IIIB - 23 (4%), IIIC - 468 (81.2%), and IV - 85 (14.8%). Optimal cytoreduction was achieved in 430 patients (74.7%), including 85 of 97 patients (87.6%) undergoing splenectomy. PSM was identified in 20 patients (20.6%) undergoing splenectomy, including 3 of 5 patients (60%) with radiographically identified parenchymal liver metastases and 17 of 92 patients (18.5%) without such radiographic findings (P=0.059). Age, preoperative albumin, residual disease, stage, bulky upper abdominal disease, IP chemotherapy, and PSM were associated with OS on univariate analysis. Splenectomy was not associated with survival. Age, preoperative albumin, residual disease, stage, and PSM (HR=0.46; 95% CI, 0.27-0.77) were associated with OS on multivariate analysis. In the subset of patients undergoing splenectomy, OS was lower for patients with PSM versus those without PSM (28.5 v 51.2months, P=0.004).
    Conclusions: PSM is independently associated with decreased OS in patients with advanced OC, FTC, and PPC. PSM occurs in the setting of other evidence of hematogenously disseminated disease, but also occurs outside this setting. PSM should be considered a criterion for stage IV disease.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Fallopian Tube Neoplasms/mortality ; Fallopian Tube Neoplasms/pathology ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/pathology ; Peritoneal Neoplasms/mortality ; Peritoneal Neoplasms/pathology ; Splenectomy ; Splenic Neoplasms/mortality ; Splenic Neoplasms/secondary ; Survival Analysis
    Language English
    Publishing date 2013-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2012.09.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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