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Cancer metastases: case report A 47-year-old woman developed cancer metastases during treatment with cisplatin and carboplatin for ovarian cancer. The woman received carboplatin AUC 5 and paclitaxel every 3 weeks for six cycles followed approximately 7 months later by six cycles of cisplatin 75 mg/m2, paclitaxel and epirubicin; approximately 10 months after completing second-line chemotherapy, she received carboplatin AUC 5 and gemcitabine. Approximately 2.5 years after starting her first treatment with carboplatin, and whilst receiving topotecan, she developed a periodical high fever and began complaining about painful swelling at her right sternocostal region. She had a palpable, nodular and slightly mobile mass, with inflammation and erythema of the overlying skin slightly above her right sternocostal joint. A CT scan showed a nodular mass, with soft tissue density that expanded a total of 8cm in length, and extended from her right sternocostal joint to her right atrium. Fine needle aspiration showed pus and tissue necrosis, but no sign of malignancy. A possible diagnosis of osteomyelitis was made. The woman received ciprofloxacin, clindamycin and teicoplanin. Her fever did not resolve, and there was no improvement in regional swelling or pain. She underwent thoracotomy and her mass was surgically resected. Histological investigation showed adenocarcinoma, which had a papillary structure among necrotic tissue and inflammatory elements, confirming metastasis. She received radiotherapy and docetaxel resulting in disease stabilisation. She later developed disease progression, and received vinorelbine; tamoxifen was later added leading to disease stabilisation. Author comment: "It has been speculated that malignant cells may become even more aggressive under the mutagenic effect of platinum compounds. . . This DNA-disruptive effect is directly related to the ability of platinums to change nonmalignant cells to invasive malignant cells." Pavlakis G, et al. Recurrent ovarian cancer metastatic to the sternum, costae, and thoracic wall after prolonged treatment with platinum-based chemotherapy: a case report and review of the literature. International Journal of Gynecological Cancer 801064869 16 (Suppl. 1): 299-303, Feb 2006 - Greece

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Reactions 22 Jul 2006 No. 1111