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Recent studies have documented prolonged expression of viral antigens and RNA and associated inflammation after infection with SARS-CoV-2 in a substantial proportion of infected patients. The persisting SARS-CoV-2 effects and findings, with inflammation associated with continued detection of viral antigens, especially resemble those previously reported for influenza virus, as well as respiratory syncytial virus (RSV). The reports indicate the need for improved insight into the mechanisms whereby post-SARS-CoV-2 infection-related illness is apparently more common and perhaps even more persistent after infection than observed for other respiratory viruses. [ABSTRACT FROM AUTHOR]

Hydatid disease is an endemic parasitic infection caused by the larval stages of the tapeworm Echinococcus. It is highly endemic in Kazakhstan, with both Echinococcus granulosus and Echinococcus multilocularis widely distributed throughout the country. Hydatid disease can affect almost any organ in the body, with the liver and lung being the most common sites, while cardiac involvement is rare. We report a case of a young female presenting with a 1-year history of stabbing precordial pain, shortness of breath, and weakness. She had a hydatid cyst involving the myocardium of the left ventricle and the left lobe of the liver. The patient underwent surgical resection and received albendazole medication as part of the treatment regimen. [ABSTRACT FROM AUTHOR]

Leptomeningeal carcinomatosis (LC) is a rare site of metastasis in solid tumors, and it is associated with poor prognosis due to disabling symptoms and a scarcity of treatment options. This condition is an uncommon entity in gastric cancer (GC). We present a case of primary LC manifestation in a patient with an incidental diagnosis of localized node-negative GC. We additionally perform a literature review and discuss the diagnostic and therapeutic challenges. In conclusion, LC from GC represents a rare condition with a dramatic prognosis. Its diagnosis might be very challenging. A multidisciplinary approach appears to be the best strategy for the management of LC from GC. [ABSTRACT FROM AUTHOR]

Primary intracranial melanocytoma is an uncommon benign pigmented tumor arising from leptomeningeal melanocytes. Neuroimaging characteristics of central nervous system melanocytoma are distinct from similarly presenting intracranial neoplasms and can aid in diagnosis prior to histopathological examination. In rare cases, there may be more than one lesion present. We report a case of a 19-year-old woman presenting with progressively worsening headaches, nausea, emesis, and generalized weakness of 2 months. Imaging revealed tumors in the parietal and ipsilateral medial temporal lobe. The patient underwent gross total resection of the parietal lesion which histopathological assessment revealed to be primary intracranial meningeal melanocytoma. This case highlights the utility of specific imaging criteria such as diffusely increased T1 signal without enhancement in the initial diagnostic evaluation of intracranial melanocytoma. We also describe the clinical characteristics, management strategy, and histopathological features of a rare case of a patient with multiple primary intracranial melanocytoma lesions. [ABSTRACT FROM AUTHOR]

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Background: Cancer-related fatigue is a prevalent condition in all stages of oncologic disease that is poorly diagnosed, with a negative impact on physical function to perform activities of daily living. Fatigue is also one of the main manifestations in post-COVID-19 syndrome, and few studies have explored the functionality of cancer patients after infection by the new coronavirus. This study was designed to assess cancer-related fatigue symptoms and their implications on physical function and quality of life during the pandemic. Methodology: An observational study with a cross-sectional survey in cancer patients ≥ 18 years of age was conducted. The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F), the perception of asthenia and performance status were evaluated, and the differences between groups according to the history of COVID-19 were calculated. Results: A total of 60 cancer patients had an average age of 33.5 ± 10.11 years, 73.3% were female, and 98.3% had an Eastern Cooperative Oncology Group-Performance Status level < 2. Severe fatigue was found in 43.3% of patients, and the average FACIT-F score was 33.5 ± 10.11. The proportion of coronavirus infection was 13,3%, and the performance of this group was worse on the scale compared to the group without infection (25 ± 10,40 vs. 34,81 ± 9,50 [p = 0,009]). There was a significant correlation between visual analog scale values and FACIT-F scale scores (Pearson's r = -0.76). Conclusion: SARS-CoV-2 infection could increase cancer-related fatigue symptoms, limiting activities of daily living and impairing quality of life. [ABSTRACT FROM AUTHOR]

Elliptocytes are most abundant in hereditary elliptocytosis. Isolated deletion 20q [del(20q)] associated with elliptocytosis in a patient with myelodysplastic syndrome (MDS) is very rare, and only a few cases are reported in the literature. This report describes a case of an MDS‑related autoimmune disease (Sjögren’s syndrome) with acquired elliptocytosis and del(20q). We discuss their clonal relationship and del(20q) status in the process of disease progression. A 58‑year‑old woman, with a history of Sjögren’s syndrome, was admitted for investigation of pancytopenia. An initial evaluation revealed a regenerative normochromic normocytic anemia with hemoglobin of 9.2 g/dL, an absolute reticulocyte count elevated at 245 × 109 /L, a platelet count of 70 × 109 /L, white blood cells of 1.4 × 109 /L, and polynuclear neutrophils (PNNs) at 0.64 × 109 /L. A slightly elevated total bilirubin of 28 µmol/L prompted a hemolytic workup. A peripheral blood smear showed frequent elliptocytes and occasional spherocytes. In addition, the PNNs were hyposegmented and hypergranular. Bone marrow aspirate smears showed significant dysplasia of all hemopoietic lineages indicating a diagnosis of multilineage dysplasia. Cytogenetic analysis showed a 20q deletion. The IPSS‑R score was 4, stratifying her to the intermediate‑risk IPSS‑R group. MDS is frequently associated with a variety of autoimmune disorders. Connective tissue diseases account for 25%–30% of MDS‑related autoimmune diseases but Sjögren’s syndrome has been rarely reported. [ABSTRACT FROM AUTHOR]

Background Trastuzumab deruxtecan (T-DXd) demonstrated unprecedented efficacy in patients with pretreated HER2+ metastatic breast cancer (mBC). However, few data are available about its efficacy in routine clinical practice. In this multicenter retrospective study, we examined effectiveness and safety of T-DXd in a real-world population. Methods Clinico-pathological information about patients with HER2+ mBC who received T-DXd were collected from 12 Italian hospitals. HER2 status was determined locally. Patients who received at least one administration of T-DXd, as any therapy line for advanced disease were included in the analysis. The primary endpoint was real-word PFS (rwPFS). Results One hundred and forty-three patients were included. Median age was 66 (range: 37-90), and 4 men were included. Hormone receptor (HR) status was positive in 108 (75%) patients and negative in 35(25%). T-DXd was administered as first, second, third, or subsequent lines in 4 (3%), 16 (11%), 42 (29%), and 81 (57%) patients, respectively. Among 123 patients with measurable disease, the ORR was 68%, and the DCR was 93% (9 CRs, 74 PRs, and 30 SD). Nine (7%) patients had a primary resistance to T-DXd. With a median follow-up of 12 months, the median rwPFS was 16 months. RwPFS was 84%, 59%, and 39% at 6, 12, and 18 months, respectively. A favorable trend in rwPFS was reported in patients receiving T-DXd as I/II line versus further lines (17 vs. 15 months; P  = .098). Any-grade toxicity was registered in 84 patients (59%). Most common adverse events (AEs) reported were nausea (33%), neutropenia (21%), and asthenia (21%). Liver toxicity and diarrhea were uncommon (5% and 1%). Severe toxicities was registered in 18% of patients, and the most frequent were neutropenia, nausea/vomiting, and ILD observed in 15, 2, and 3 patients. AEs led to dose reduction in 37 patients (26%). Dose reduction and AEs do not affect patients' response and survival outcomes. Conclusions Efficacy and safety of T-DXd were confirmed in an unselected real-world population of HER2+ mBC. These results are consistent with the results of known findings, and no new safety concerns were reported. [ABSTRACT FROM AUTHOR]