Early distant relapse after optimal local control in locally advanced rectal cancer.

We present a case of locally advanced rectal cancer with initial optimal local control after neoadjuvant concurrent chemoradiotherapy followed by surgery; early liver recurrence then occurred and was treated again with curative intent with neoadjuvant combination chemotherapy followed by liver surgery. We reflect on this difficult problem and discuss relevant topics to this case report.

A patient with breast cancer with hepatic metastases and a complete response to herceptin as monotherapy.

The majority of deaths due to breast cancer occur in the context of complications secondary to metastatic disease. Trastuzumab, as a second line treatment, has shown a 15% objective response rate in patients with metastatic breast cancer. We present the case of a patient with two breast tumours, the second of more aggressive characteristics, with negative hormone receptors and c-erb-B2 +++, and with few therapeutic options due to her hepatic insufficiency secondary to metastatic disease; she was administered herceptin as monotherapy, and she had a complete clinical response.

Cushing's paraneoplastic syndrome as first manifestation of an adenocarcinoma of unknown origin.

Small cell lung cancer is the most common cause of paraneoplastic Cushing's syndrome. The definitive treatment consists in surgical removal of the tumour, which is not possible in most of these cases (they are often diagnosed at advanced stages), and therefore it is frequently necessary adding the drug ketoconazol. We hereby present the case of a patient diagnosed with a metastatic carcinoma of unknown origin associated with two paraneoplastic syndromes: a Cushing's syndrome and a sensitive-motor axonal neuropathy, a very uncommon association.