Abstract INTRODUCTION Racotumomab is a therapeutic vaccine based on a monoclonal anti-idiotypic antibody developed by the Molecular Immunology Center in Havana, Cuba, that is registered in Cuba and Argentina for treatment of non-small cell lung cancer. It induces a specific humoral and cellular immuneresponse against the N-glycolyl GM3 (NeuGcGM3) ganglioside present in tumor cells, thereby provoking the death of these cells. OBJECTIVE Evaluate racotumomab vaccine use as switch maintenance and second-line therapy for patients with inoperable non-small cell lung cancer in routine clinical practice, outside the framework of clinical studies, and assess the overall survival, stage-specific survival and safety in these patients. METHODS A descriptive, retrospective study was carried out in patients diagnosed with non-small cell lung cancer not suitable for surgical treatment, who received racotumomab as a part of switch maintenance or second-line treatments. Overall survival was defined from diagnosis and from the first immunization, until death. RESULTS We included 71 patients treated with racotumomab, 57.7% (41/71) of whom were in stages IIIB and IV of non-small cell lung cancer. Of the patients, 84.5% (60/71) had no adverse events, and 15.5% (11/71) had mild adverse reactions. The median overall survival was 24.5 months, calculated from the first immunization, 17.2 months for those who received racotumomab as switch maintenance and 6.8 months for patients who had progressed after the first line of treatment. CONCLUSIONS Racotumomab in routine clinical practice prolonged overall survival in patients with non-small cell lung cancer treated in switch maintenance, and in stage IV patients who received the treatment as second-line therapy. The vaccine was well tolerated.

Abstract Pheochromocytoma is a chromaffin cell tumor that is considered rare. Approximately 10% are malignant and 90% benign, their behavior is determined by local invasion and the presence of distant metastases. We present a case of malignant extraadrenal pheochromocytoma with metastases to the sternum and other bone structures, after 29 years of a right nephrectomy for this disease, at the level of the body of the 1st left rib bone and the body of the 2nd cervical vertebra, bones of the cranial vault and the upper portion of the sternum, evidencing the atypical and unusual behavior of dissemination.

Resumen El feocromocitoma es un tumor de células cromafines que se considera poco frecuente. Aproximadamente el 10% son malignos y el 90% benignos, su comportamiento está determinado por la invasión local y la presencia de metástasis a distancia. Se presenta un caso de feocromocitoma extraadrenal maligno con metástasis en el esternón y otras estructuras óseas, tras 29 años de una nefrectomía derecha por esta enfermedad, a nivel del cuerpo del 1.er hueso costal izquierdo y el cuerpo de la 2.a vértebra cervical, huesos de la bóveda craneana y la porción superior del esternón, evidenciando el comportamiento atípico y raro de diseminación.