The use of immune checkpoint inhibitors has dramatically improved the chance of surviving malignant melanomas; however, the effect comes at the cost of toxicities that are difficult to predict. Immune-mediated hepatitis is the most common form of liver toxicity, but fatal outcome is uncommon. https://www.selleckchem.com/products/oul232.html We report the case of a 70-year-old female with metastatic malignant melanoma who developed severe liver toxicity characterized by bile duct injury and cholestasis. The condition progressed despite potent immunosuppressive treatment, plasmapheresis, and intensive supportive care; and the patient died while still having tumor response.Idiopathic thrombocytopenic purpura (ITP) is a disease in which the immune system attacks platelets and causes decrease in its number exposing the patient to risk of bleeding. It is diagnosed by exclusion. Eltrombopag is a thrombopoietin receptor agonist which is used as second-line treatment for patients with ITP. The usual starting dose is 25 mg daily and maintenance dose is 75 mg daily. Little is known about the dose of eltrombopag in patients with sleeve gastrectomy since reduction in the amount of functioning gastrointestinal tract after gastric bypass surgery leads to decreased time to drug absorption and reduced drug bioavailability. Here we are reporting a 46-year-old female with ITP and sleeve gastrectomy who responded to low-dose eltrombopag 25 mg every other day, which is equivalent to 12.5 mg daily, and maintained adequate platelet counts on this dose.Soft tissue sarcomas are common neoplasms accounting for 1% of all adult malignancies; however, soft tissue sarcomas infrequently arise from the abdominal viscera. Many case reports discuss gastric and esophageal neoplasms. In the group of gastrointestinal liposarcomas, primary duodenal liposarcomas are among the rarest, with only three previous cases reported in the literature. Herein, we discuss a case of primary duodenal liposarcoma. A 59-year-old woman presented with symptoms consistent with anemia raising suspicion for an upper gastrointestinal bleed. Upper endoscopy revealed an ulcerated mass in the first portion of the duodenum. The patient underwent a segmental duodenal resection and distal gastrectomy with Roux-en-Y reconstruction. A diagnosis of dedifferentiated liposarcoma was rendered on the resected specimen. At 16 months' follow-up, the patient remains without evidence of disease recurrence. We have presented a case of primary duodenal liposarcoma, which is among the rarest locations for gastrointestinal sarcomas with only three previous reports in the literature. Liposarcomas should be included in the differential for submucosal masses of the duodenum. An isolated metachronous recurrence in the mesorectum from a primary ascending colon cancer is a rare finding that has not been previously reported. This may represent a form of retroperitoneal spread, sometimes referred to as "drop metastasis," which is an uncommon mechanism for metachronous recurrence. A 38-year-old male presented to the Emergency Department in January of 2018 with profound anemia. A colonoscopy revealed innumerable colonic polyps. He reported having multiple family members diagnosed with colon cancer and was subsequently diagnosed with familial adenomatous polyposis with rectal sparing. Total abdominal colectomy with ileorectal anastomosis was performed, revealing a T3N1a adenocarcinoma of the ascending colon. The patient subsequently underwent 12 cycles of adjuvant FOLFOX. Surveillance imaging in late 2019 revealed a suspicious mass in the superior perirectal soft tissue without any other sites of potential disease. Completion proctectomy was performed in January 2020, 2 years after the initial resection. Pathology revealed a mesorectal tumor deposit located 1.5 cm distal to the ileorectal anastomosis. No evidence of mucosal involvement or nodal metastasis was identified. Isolated mesorectal recurrence is a rare and previously unreported clinical finding following resection of an ascending colon cancer with an ileorectal anastomosis. This likely represents a form of retroperitoneal spread. Isolated mesorectal recurrence is a rare and previously unreported clinical finding following resection of an ascending colon cancer with an ileorectal anastomosis. This likely represents a form of retroperitoneal spread.Melanoma metastasis from an unknown primary cancer has an incidence of 3.2% among melanoma patients. Furthermore, paraneoplastic neurological syndromes (PNS) are rare, occurring in 1-3% of patients with malignancies. Paraneoplastic cerebellar degeneration (PCD) is one of the classic PNS and is characterized by acute or subacute onset of ataxia and/or presence of onconeural antibodies. A 61-year-old male with ataxia, vertigo, and headache later developed dysarthria, multidirectional nystagmus, hyperactive delirium, auditory hallucinations, psychomotor agitation, and myoclonus. Toxicological, metabolic, infectious, and autoimmune etiologies were assessed and reported negative. An osteolytic lesion was observed in the right iliac crest via computed tomography (CT). A positron emission tomography-CT reported increased fluorodeoxyglucose uptake of a right iliac and right inguinal ganglion. After biopsy of the right inguinal ganglion, a BRAF mutation-positive melanoma metastasis from an occult primary cancer was diagnosed. Dermatologic, ophthalmologic, and endoscopic gastrointestinal assessment did not reveal a primary malignant melanoma. The patient's movement disorders and neuropsychiatric symptoms improved with quetiapine, prednisone, azathioprine, and cyclophosphamide. Oncological management was conducted with MAPK pathway inhibitors (i.e., dabrafenib and trametinib). Movement disorders associated with neuropsychiatric symptoms are complex to diagnose. PNS are rare and often associated with antibodies against neural antigens expressed by the tumor. The case presented above describes a patient with a BRAF-positive malignant melanoma metastasis from an occult primary associated with PCD - to the best of our knowledge, the first reported in the literature.Cutaneous metastases from visceral carcinomas are relatively uncommon, with an overall incidence ranging from 0.7 to 9%. Diagnosis of scalp metastases usually escapes clinicians and dermatologists due to the fact that these metastases are mimicking other benign dermatological conditions. Herein, we present an uncommon case of scalp alopecia neoplastica mimicking alopecia areata due to breast cancer; a 43-year-old woman diagnosed with lobular cancer 3 years previously presented with acute loss of hair in well-circumscribed areas of the scalp and was diagnosed with alopecia areata by a private-practice dermatologist. She was then reevaluated, and due to her history of breast cancer, a biopsy from the scalp was performed and revealed alopecia neoplastica. At the same time that the skin lesions were recognized as disease involvement, the patient presented with dyspepsia, and endoscopy of the upper and lower gastrointestinal tract also revealed metastasis to the stomach and bowel. Gastrointestinal metastasis may occur with several types of cancer, but the stomach and bowel are rare metastatic sites for breast cancer.