Vanishing bile duct syndrome: a sequela of temozolomide and levetiracetam-induced cholestatic liver injury.

Temozolomide (TMZ)-levetiracetam (LEV) combination therapy in glioblastoma management is gradually becoming a mainstay treatment given its superior effect compared with TMZ monotherapy. While there have been previous cases of hepatotoxicity, there are no prior reports of vanishing bile duct syndrome (VBDS) associated with TMZ-LEV combination use. This case report details a male in his 50s who had recently completed TMZ and LEV for right frontal lobe glioblastoma.

Tricuspid Valve Vegetation Secondary to Ovarian Cancer Leading to Acute Stroke via Pulmonary Arteriovenous Malformation.

We report a case of non-bacterial thrombotic endocarditis in a 52-year-old woman due to ovarian cancer that was complicated by acute ischemic stroke through pulmonary arteriovenous malformation. Echocardiography showed tricuspid valve vegetation and a positive bubble study that revealed pulmonary arteriovenous malformation in the absence of patent foramen ovale. The patient opted for palliative management and was discharged home with comfort care.