Colorectal cancer (CRC) poses a significant global health challenge, particularly with patients often experiencing liver metastases. Surgical resection remains the standard treatment; however, many patients face ineligibility due to disease status, contributing to poor prognoses. Liver transplantation (LT) is a viable alternative for select patients with advanced disease. This case report details the clinical outcomes of two CRC patients with multiple liver metastases who successfully underwent living donor LT (LDLT). Both individuals had intricate medical histories and pre-existing liver issues. Patient 1, a 58-year-old male, received extensive pre-transplant interventions, including multiple radiofrequency ablations and pulmonary resections. Patient 2, a 50-year-old male, had cirrhosis alongside colorectal cancer with liver metastases and completed chemotherapy. The cases illustrate LDLT's viability and potential advantages for complex CRC cases with liver metastases. The patients’ intricate medical backgrounds necessitate thorough pre-transplant evaluations and vigilant post-transplant supervision. Moreover, these cases highlight the critical nature of ongoing follow-up for evaluating long-term survival and recognizing possible complications.

BACKGROUND AND PURPOSE: The objective of this study was to determine the frequencies of different clinical presentations and the phenotypic spectrum of multiple sclerosis (MS). METHODS: This cross-sectional study was performed in the Neurology Department of King Fahd Hospital of University Alkhobar in the Kingdom of Saudi Arabia (KSA). Data of 190 MS patients who fulfilled the McDonald criteria were retrieved from medical records and analyzed. RESULTS: The age at disease onset was 26.27±8.2 years (mean±SD) and disease duration was 6.38±5.10 years. The male-to-female ratio was 1:1.6. Optic neuritis and myelitis were the most-frequent first clinical presentations. Sensory (73.1%), motor (61%), and visual (58.4%) symptoms were the most-frequent established clinical symptoms. Relapsing-remitting multiple sclerosis (RRMS) was present in 75% of the cases. Supratentorial T2-weighted white-matter lesions and deep-gray-matter or juxtacortical lesions were the most-frequent magnetic resonance imaging (MRI) lesions, comprising 28% and 23.7% of all MRI lesions observed in 93.6% and 79.4% of the cases, respectively. The scores on the Expanded Disability Status Scale were within the range of 1.0–5.5 in 82.1% of the patients. There were 145 (76.3%) patients taking interferon β therapy. CONCLUSIONS: MS presenting in the hospital setting is more common in KSA than reported previously, and the number of diagnosed cases in increasing. It is therefore an emerging and disabling neurological illness in KSA with clinical characteristics not dissimilar to those in other middle eastern countries. A decrease in the frequency of patients with secondary progressive multiple sclerosis (SPMS) indicates either that more new cases of RRMS are being diagnosed or that adequate treatments of RRMS are preventing the evolution to SPMS. Further larger and population-wide epidemiological and clinical studies with the long-term follow-up of MS patients are required to better assess the clinical spectrum of MS in KSA.
Cross-Sectional Studies ; Epidemiology ; Follow-Up Studies ; Humans ; Interferons ; Magnetic Resonance Imaging ; Medical Records ; Multiple Sclerosis* ; Multiple Sclerosis, Chronic Progressive ; Multiple Sclerosis, Relapsing-Remitting ; Myelitis ; Neurology ; Optic Neuritis ; Phenotype ; Prevalence ; Saudi Arabia*