22-Year-Old Arrives at Hospital After Injury, Learns He Has Rare and Deadly Cancer

A 22-year-old from Jerusalem arrived at the emergency department at the Shaare Zedek Medical Center after suffering an injury to his chest, while also experiencing a bloody cough. Upon his arrival, the imaging team carried out a routine CT scan, which revealed a bleeding mass in his lung. He was rushed into emergency surgery to remove it, led by the head of the cardiothoracic surgery department, Dr. Dani Fink.

After pathology tests were received from the tumor, another surprising finding emerged, Zohib had angiosarcoma, a tumor that develops in the cells lining blood vessels or the lymphatic system. "Angiosarcoma is an aggressive and rare tumor, and it has a high chance of developing resistance to the standard treatment protocols used worldwide," says Dr. Daniella Katz, head of the sarcoma unit. Imaging tests, carried out under her direction, found that he had metastases in the chest and scalp, and he was referred for continued treatment in the oncology department headed by Prof. Nir Peled.

For six months, Zohib underwent intensive chemotherapy treatments, which succeeded in temporarily stabilizing the disease, but tumor remnants remained in the lung. At that stage, the treatment team, led by Dr. Katz and Dr. Basel Dabah, an oncology resident, decided to change course. In an unusual step, and after relying on a small number of reports in the global literature, they chose a unique treatment strategy for sarcomas, a combination of a chemotherapy regimen and immunotherapy to boost the immune system, a treatment known in other types of cancer but not commonly used for angiosarcoma.

"As far as is known in the world, there is very little information about the effect of immunotherapy on a tumor of this type after completion of chemotherapy. However, in a groundbreaking development, after Zohib received the immunotherapy, the disease completely regressed and Zohib has been disease-free for more than a year," Dr. Katz explains. Zohib continued to receive immunotherapy alone, and follow-up PET-CT scans, a year after the disease regressed, showed that the cancer had disappeared completely, an unusual and exceptional result in such an aggressive disease.

"We must not give up on medical creativity and hope," Dr. Katz adds. "When it comes to a rare and aggressive tumor, it is our duty as caregivers to step outside the conventional path and learn from combined treatment approaches that have already proven themselves in other cancers. In the case of such a young patient, a combination of multidisciplinary teamwork and an in-depth search for global experience led to this extraordinary and moving result. For us, it is a reminder that even in the most complex cases, we must not give up on medical creativity and hope."

The head of the oncology division at Shaare Zedek, Prof. Nir Peled, said, "We feel tremendous satisfaction from treating this case, which helps enrich medical knowledge in the field and is, in effect, writing the oncology textbooks through the treatment successes we are leading. Thanks to creative thinking, a commitment to excellence, and the desire to research, give and treat, the teams in our oncology division are among the best in Israel."

Zohib said, "I have returned to life and work in full after a very difficult period. Thanks to the early detection and the unique treatment, I recovered against all odds. My message to everyone is to get checked and never give up. I want to say a big thank you to the amazing team at Shaare Zedek that saved my life."