Metastatic Ovarian Cancer Presenting With Painful Finger Ischemia

Patient Info: Anonymized, Female | Stage Metastatic/Advanced

Biomarkers: CA-125: 90.6 kU/L after 4 cycles of chemotherapy

Metastatic Site: peritoneum|omentum

She continued chemotherapy and palliative symptom management after debulking surgery. She died from an intracranial hemorrhage 10 months after her original presentation.

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Gastric Cancer: Alan's Patient Story

Patient Info: Alan Salm, Male, 50s | Stage Metastatic/Advanced

Alan died from stomach cancer on May 5, 2021, 1 month before his 53rd birthday.

Metastatic Follicular Carcinoma Arising From Struma Ovarii

Patient Info: Anonymized, Female | Stage Metastatic/Advanced

Metastatic Site: right fallopian tube|peritoneum|omentum|bladder…

Four years after diagnosis, she had no evidence of recurrence or metastasis while continuing thyroid-hormone suppression and 6-monthly surveillance.

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Recurrent Ovarian Cancer and Olaparib-Related Skin Toxicity

Patient Info: Anonymized, Female | Stage Metastatic/Advanced

Metastatic Site: peritoneum|liver

The latest chemotherapy was effective, and she was alive without signs of another recurrence at the last documented follow-up.

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Ovarian Cancer Metastasis to the Cervical Spinal Canal

Patient Info: Anonymized, Female, 70+ | Stage Metastatic/Advanced

Metastatic Site: brain|cervical intradural extramedullary space

Her neck and shoulder pain resolved after spinal surgery, but she developed recurrent brain disease and died from cachexia 4 months after the spinal operation.

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Metastatic Clear Cell Ovarian Cancer Complicated by Treatment-Related Sarcoidosis

Patient Info: Anonymized, Female, 60s | Stage Metastatic/Advanced

Metastatic Site: peritoneum

During a treatment holiday, biopsy and laboratory evaluation showed treatment-related sarcoidosis rather than ovarian-cancer spread in the enlarged lymph nodes. After prednisone, the sarcoidosis resolved and imaging showed no progression of the clear cell ovarian cancer; she remained clinically well 4 months later.

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Amy Marshall: Her Mother’s Stomach Cancer

Patient Info: Anonymized, Female | Stage Metastatic/Advanced

She died in 2003 after a rapid course of stomach cancer that had already spread when diagnosed.

Gastric Adenocarcinoma: Donny's Patient Story

Patient Info: Donny, Male, 40s | Stage Metastatic/Advanced

Metastatic Site: multiple organs

He died at age 47 after a 4-day hospitalization; biopsy results after death identified diffuse gastric adenocarcinoma.

Dan Kane: His Sister’s Gastric Cancer Journey

Patient Info: Anonymized, Female | Stage Metastatic/Advanced

Her gastric cancer returned after partial gastrectomy and had spread by the time she underwent total gastrectomy.

Kidney Disease During Treatment for Metastatic Gastric Cancer

Patient Info: Anonymized, Male, 70+ | Stage Metastatic/Advanced

Metastatic Site: liver

His condition worsened with nephrotic syndrome, malnutrition, treatment side effects, and progressing metastases. He died 5 months after the kidney biopsy following a fatal cerebral bleed.

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Gastric Cancer Forming a Fistula Into the Liver

Patient Info: Anonymized, Female, 70+ | Stage Metastatic/Advanced

Metastatic Site: liver|lungs

The cancer recurred locally with liver deposits 4 months after surgery and later spread to the liver and lungs. She declined further treatment, entered palliative care, and died in hospital about 2 months later.

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MSI-High Malignant Struma Ovarii With Lung and Liver Metastases 17 Years Later

Patient Info: Anonymized, Female, 50s | Stage Metastatic/Advanced

Biomarkers: NRAS, and ATM mutations; Ki-67 approximately 15%–29%

Metastatic Site: lungs|liver

She remained asymptomatic and tolerated pembrolizumab without obvious adverse effects after 4 doses, with follow-up imaging planned for metastatic lung and liver disease.

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Breast cancer returned in the stomach and peritoneum after three years in remission

Patient Info: Anonymized, Female, 60s | Stage Metastatic/Advanced

Biomarkers: Initial breast tumor: ER 95%, PR 5%, HER2-negative, Nottingham grade 2. Metastatic peritoneal tumor: ER 80%

Metastatic Site: stomach; peritoneum

After metastatic breast cancer was confirmed in the stomach and peritoneum, she chose palliative care and inpatient hospice and died a few weeks later.

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Metastatic Gastric Cancer Causing Severe Hormone-Related Complications

Patient Info: Anonymized, Male, 70+ | Stage Metastatic/Advanced

Biomarkers: HER2 negative; Ki-67 70%; CD56 positive; synaptophysin positive; weak chromogranin expression; ectopic ACTH secretion; elevated serum chromogranin A

Metastatic Site: liver

His liver metastases enlarged despite carboplatin, and his weight loss, appetite, and mobility worsened. He received palliative care during a later admission and died a few days afterward.

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Lung Cancer Metastases to Both Kidneys Causing Kidney Failure

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: PD-L1 highly expressed

Metastatic Site: brain|bilateral kidneys|lungs

The cancer progressed in both kidneys and lungs despite treatment, causing dialysis-dependent kidney failure. He later developed severe respiratory illness and died 5 days after readmission.

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Rapidly Progressive Stage IIIA2 Ovarian Cancer With Anaplastic Features

Patient Info: Anonymized, Female, Under 40 | Stage Metastatic/Advanced

Biomarkers: CA-125 419 IU/mL; CA19-9 elevated; lactate dehydrogenase elevated

Metastatic Site: lungs|liver

Within 30 days of surgery, the cancer had progressed with a large retroperitoneal nodal mass and new lung and liver metastases. She died from advanced ovarian cancer 5 weeks after surgery.

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HER2-positive left breast cancer treated with trastuzumab and mastectomy

Patient Info: Anonymized, Female, 60s | Stage Metastatic/Advanced

Biomarkers: ER-negative; PR-negative; HER2/CerbB2 strongly positive; BRCA1/2 negative for known pathogenic variants; FANCA variant of uncertain significance.

She remained alive, asymptomatic, and disease-free while undergoing annual surveillance after treatment for the left HER2-positive breast cancer.

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Low-dose intrapleural therapy relieved a complex malignant pleural effusion

Patient Info: Anonymized, Female, Under 40 | Stage Metastatic/Advanced

Biomarkers: EGFR mutation-negative; ALK alteration-negative; ROS1 alteration-negative.

Metastatic Site: pleura; adrenal gland; bone

The lung cancer had progressed after initial chemotherapy, but rescue treatment of the infected loculated pleural effusion drained 2,000 mL, resolved the collection, and improved her breathing and fever.

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Lung cancer remission after pembrolizumab despite severe inflammatory arthritis

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: PD-L1-positive.

Metastatic Site: brain (temporal and parietal lobes)

The lung adenocarcinoma remained in complete remission 28 months after diagnosis, while the treatment-related arthritis also reached sustained remission and he returned to work and exercise.

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Gastric Cancer Presenting With Painful Skeletal Muscle Metastases

Patient Info: Anonymized, Male, 40s | Stage Metastatic/Advanced

Metastatic Site: skeletal muscles

He had painful skeletal muscle metastases, an ECOG performance score of 3, and advanced gastric cancer that was not suitable for tumor-directed treatment. His care focused on palliation and end-of-life support.

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Locally advanced male breast cancer associated with a pathogenic ATM variant

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: ER 100% positive; PR 100% positive; HER2-negative; Ki-67 30%; germline pathogenic ATM variant c.2921+1G>A.

Two years after diagnosis, he had an ECOG performance status of 0 and remained without signs of breast-cancer relapse or another primary cancer.

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NRG1-Fusion Lung Cancer With a 24-Month Response to Afatinib

Patient Info: Anonymized, Female, 50s | Stage Metastatic/Advanced

Biomarkers: NRG1 fusion; KRAS/EGFR/ALK/ROS1/ERBB2 alterations not detected

Metastatic Site: left lung

Her cancer progressed during atezolizumab, and she died in May 2019.

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Metastatic NRG1-Fusion Lung Cancer Responding to Long-Term Afatinib

Patient Info: Anonymized, Female, 60s | Stage Metastatic/Advanced

Biomarkers: CD74-NRG1 fusion

Metastatic Site: lungs

As of February 2020, she remained on afatinib 30 mg daily with an ongoing partial response after 27 months.

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Recurrent NRG1-Fusion Lung Cancer After Surgery and Immunotherapy

Patient Info: Anonymized, Male, 60s | Stage Metastatic/Advanced

Biomarkers: SDC4-NRG1 fusion

He chose no further treatment after rapid progression on afatinib and died shortly afterward in hospice.

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