Tumor treating fields (TTFields) therapy at 200 kHz is FDA-approved for supratentorial glioblastoma.However, reports of TTFields in patients with infratentorial high-grade glioma (HGG) are rare. Two patients with infratentorial HGG received off-label 200 kHz TTFields. To reduce impaired neck range of motion, the electrode transducer arrays were “skeletonized” by cutting a portion of the adhesive material. The electrode arrays were applied with the neck in flexion to further promote range of neck motion. Patient 1, a 22-year-old man with high-grade diffuse pontine glioma with recurrences and prior treatments, tolerated TTFields combined with systemic treatment (initially with a bifunctional DNA alkylating agent; subsequently with temozolomide and bevacizumab) for 5 months with stable disease for 4 months. He experienced grade 1 rash (neck). Patient 2, a 58-year-old woman with diffuse glioma of the brainstem (H3K27M-mutated) with multiple recurrences and prior treatments, tolerated TTFields combined with systemic treatment (lomustine and bevacizumab). With the TTFields + systemic combination therapy, the patient was stable for 8 months with no TTFields-related side effects. We provide two initial post-marketing cases demonstrating that off-label use of 200 kHz TTFields in infratentorial HGG is safe and feasible. Prospective studies are necessary to validate the efficacy of this approach.

Background: and Purpose Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT). Methods: The 2016–2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality. Results: Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes. Conclusion Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.

Various different objects have been reported to strangulate the penis. We reported on a patient who used metal radiator clamps for an extended period of time. Workup included history, physical examination and urinalysis. The patient was taken to the operating room for further evaluation with cystourethroscopy and orthopedic wire cutters were used to break the metal bands.
Constriction, Pathologic ; Humans ; Male ; Middle Aged ; Penile Diseases ; etiology ; Penis ; injuries ; Rupture ; therapy