Journal of Cancer and Tumor International

Epidemiological Data Gaps in Breast Cancer Research in Cameroon: A Meta-analysis

2026-05-28T13:54:03+00:00

Background: Breast cancer is the leading malignancy among women in Cameroon, yet national decision-making still relies heavily on international estimates, isolated hospital series and incompletely documented registries. This limitation weakens the interpretation of incidence, prevalence, mortality, survival and treatment indicators, and may delay evidence-based cancer control planning. This systematic review and meta-analysis aimed to synthesize the published evidence on breast cancer in Cameroon, quantify key epidemiological and clinical outcomes, and identify methodological gaps that compromise national comparability.

Methods: We conducted a systematic review and meta-analysis of observational studies reporting breast cancer data from Cameroon between 1 January 2000 and 30 April 2025. MEDLINE/PubMed, EMBASE, Google Scholar and the WHO Global Health Library were searched without language restriction. Eligible designs included cohort, cross-sectional, case-control and retrospective hospital-based studies reporting at least one of the following outcomes: prevalence, incidence, mortality, five-year survival, clinical stage, histological profile, immunohistochemistry or treatment patterns. Study quality was assessed using the Newcastle-Ottawa Scale. Pooled proportions were estimated using random-effects models after Freeman-Tukey double-arcsine transformation, with heterogeneity quantified using Cochran's Q and I2 statistics.

Results: Fifty-six studies including 41,494 breast cancer patients were retained. The mean age was 45.97 ± 5.53 years, and women represented 96.3% of reported cases. Breast cancer accounted for a pooled 32% of female cancers (95% confidence interval [CI]: 14%-57%; I2=97%). The pooled mortality proportion was 72% (95% CI: 6%-99%; I²=97.7%), while pooled five-year overall survival was 36% (95% CI: 26%-47%; I2=92.2%). Most patients were diagnosed at advanced stages, with stage III and IV disease accounting for the majority of reported cases. Ductal carcinoma was the dominant histology. Hormone receptor positivity was frequent (estrogen receptor: 82%; progesterone receptor: 56%), whereas HER2 overexpression was less frequently reported (14%). Treatment reporting was incomplete: chemotherapy and radiotherapy were commonly documented, but endocrine therapy and palliative care were substantially underreported.

Conclusion: Published breast cancer research from Cameroon indicates a severe clinical burden marked by late diagnosis, high mortality and poor five-year survival. However, the extreme heterogeneity and inconsistent reporting across studies show that the country's breast cancer evidence base remains structurally fragile. Standardized cancer registration, harmonized minimum datasets, routine immunohistochemistry, active survival follow-up and transparent treatment documentation are urgently needed to support effective breast cancer control in Cameroon.

Assessment of Nutritional Concerns and Parental Information Needs in Pediatric Oncology Patients Surveyed at Benghazi Pediatric Hospital

2026-06-08T11:56:13+00:00

Background: Childhood cancer remains a major global health concern, with treatment-related nutritional complications significantly affecting outcomes and quality of life despite survival rates improving. Parents of children with cancer face significant emotional, psychological, and financial strain, often accompanied by fear of poor outcomes. Providing clear and accurate information is essential to help children understand their condition, support informed decision-making, reduce anxiety and depression, and strengthen trust between families and healthcare professionals.

Aim: This study aimed to assess the nutritional concerns experienced by pediatric oncology patients and to identify the nutrition-related information needs of their parents at Benghazi Pediatric Hospital, Libya.

Study Design: A cross-sectional study was conducted from January to April 2024 on patients attending the Children's Hospital in Benghazi, Libya. In total, participants were selected from the hospital 61 including 32 females and 29 males. They were randomly selected from the oncology ward. Collecting patients’ data and assessing the nutritional problems in children with cancer and the information needs of their parents by using questionnaires.

Results: The results show that 78.7% had received Chemotherapy. The most prominent nutritional problems that their children experienced were fatigue/weakness (74%), Taste alteration (72.2%), and anorexia (72.1%). The parents mostly needed information about food-disease interactions (80.3%), food-drug interactions (72.1%), the child’s diet (75%) and food preservation (70.4%). There was a strong correlation between food disease reaction (p=0.028), nutrition education (p=0.011) and income. There was no relationship between the information needs and gender and education level of parents. There was no relationship between type of cancer, treatment and gender, age and weight. There was no relationship between nutritional problems and age and weight

Conclusion: The findings of this study indicate that most children experience at least one nutritional concern, underscoring the importance of providing parents with comprehensive, up-to-date, and ongoing nutrition-related information to support informed dietary practices.

Epidemiological Profile of Childhood Malignancies at Korle Bu Teaching Hospital, Ghana: A Retrospective Cross-Sectional Study (2019–2023)

2026-06-26T12:39:06+00:00

Aim: This study assessed the epidemiological profile, treatment modalities, and treatment outcomes of childhood malignancies managed at Korle Bu Teaching Hospital, Ghana, from 2019 to 2023.

Study Design: A retrospective cross-sectional study was conducted.

Place and Duration of Study: The study was conducted at Korle Bu Teaching Hospital, Accra, Ghana, using records from 1 January 2019 to 31 December 2023.

Methods: Data were extracted from the childhood cancer register for children aged 0–14 years who were diagnosed and managed for malignancy during the study period. Records with incomplete key variables and duplicates were excluded. Sociodemographic characteristics, cancer type, National Health Insurance Scheme coverage, treatment modality, and treatment outcome were summarised using frequencies and percentages. Associations between selected variables and treatment outcome were assessed using chi-square tests and logistic regression.

Results: Of 732 recorded childhood cancer cases, 654 complete records were included in the analysis. The number of recorded cases declined from 142 in 2019 to 112 in 2023. Children aged 0–4 years accounted for the largest proportion of cases, representing 297 cases (45.4%). Males constituted 371 cases (56.7%). Most children had National Health Insurance Scheme coverage, 470 (71.9%). Acute lymphoblastic leukaemia was the most common malignancy, accounting for 125 cases (19.1%), followed by retinoblastoma, 110 (16.8%), and Wilms tumour, 87 (13.3%). Chemotherapy was the most frequently used treatment modality, 409 (62.5%), followed by combined treatment, 205 (31.3%). Treatment modality was significantly associated with treatment outcome. In the multivariable analysis, combined treatment was associated with lower odds of death, whereas absence of treatment was associated with higher odds of death.

Conclusion: Childhood malignancies managed at Korle Bu Teaching Hospital during 2019–2023 were most frequent among children under five years, with acute lymphoblastic leukaemia being the leading diagnosis. Strengthening early diagnosis, treatment access, financial protection, and multicentre cancer surveillance may improve paediatric oncology outcomes in Ghana.

Tumor Lysis Syndrome in Patients Treated with Chimeric Antigen Receptor T-cell Therapy: A Retrospective Study

2026-06-29T14:20:56+00:00

Background: Chimeric antigen receptor T-cell (CAR T-cell) therapy has revolutionised cancer treatment, particularly for relapsed or refractory haematological malignancies. However, treatment-related toxicities, including tumour lysis syndrome (TLS), remain a significant concern. This retrospective study aimed to evaluate the incidence, healthcare outcomes and systemic complications in patients who developed TLS secondary to CAR T-cell therapy.

Methods: Using the National Inpatient Sample (NIS) database from 2017 to 2019, adult hospitalisations with an ICD-10 procedure code for CAR T-cell therapy were identified. Cases were stratified into two cohorts based on the presence or absence of a secondary diagnosis of TLS. The primary outcomes evaluated were in-hospital mortality, length of stay (LOS) and total hospital charges. Secondary outcomes included systemic complications such as sepsis, acute kidney injury (AKI) and organ failure. Multivariable logistic and linear regression analyses were performed to adjust for baseline demographics, hospital characteristics and the Charlson Comorbidity Index.

Results: Among 685 CAR T-cell therapy inpatient encounters, 58 hospitalisations developed TLS, representing an incidence rate of 8.47% (58/685). Demographics and baseline comorbidities were comparable between the two cohorts. The development of TLS was associated with nearly fivefold higher odds of in-hospital mortality (12% vs. 2.7%; aOR: 4.72, 95% CI: 1.61 to 13.80, $p < 0.01$), a prolonged mean length of stay (26.6 vs. 19.1 days; adjusted coefficient: 6.66 days, 95% CI: 1.41 to 11.90, $p = 0.013$) and a substantial increase in mean total hospital charges ($1,421,658 vs. $826,336; adjusted coefficient: $498,757, 95% CI: $138,090 to $859,424, $p < 0.01$). Furthermore, patients who developed TLS experienced a significantly higher incidence of severe systemic complications, including acute kidney injury, the need for haemodialysis, sepsis, acute respiratory failure, pneumonia and encephalopathy.

Conclusion: TLS secondary to CAR T-cell therapy is a highly morbid toxicity associated with a nearly fivefold increase in hospital mortality, prolonged hospitalisation and a substantial economic healthcare burden. It is associated with severe multi-organ dysfunction and infectious complications. Structured prophylactic protocols and vigilant early monitoring strategies are important to mitigate these risks and improve survival outcomes in CAR T-cell recipients.

A Hybrid Extended Cox-frailty and Random Forest Framework for Prostate Cancer Survival: Integrating Clinical Interpretability with Machine Learning Performance

2026-08-08T09:48:48+00:00

Prostate cancer risk stratification in low-resource clinical settings requires survival-prediction tools that address violations of the proportional hazards assumption, unobserved patient heterogeneity, and nonlinear covariate interactions that classical regression frameworks cannot represent. This study develops a Hybrid Extended Cox–Frailty and Random Forest (Hybrid Cox-RF) model using a retrospective cohort of 200 patients with prostate cancer from a Ghanaian tertiary hospital (161 deaths, 80.5%, over the full follow-up period; 3 competing other-cause deaths, 1.5%; and 36 censored observations, 18.0%). A sequential pipeline was applied: (1) Aalen–Johansen competing-risks quantification; (2) Schoenfeld residual-based testing of the proportional hazards (PH) assumption; (3) extended Cox modelling with time-varying covariates for four confirmed PH violators; (4) gamma frailty correction; (5) six machine-learning classifiers benchmarked by 10-fold stratified cross-validation at a fixed 24-month mortality horizon (112 of 200 patients, 56.0%, died by 24 months); and (6) construction of the Hybrid Cox-RF model by embedding out-of-bag Random Forest logit risk scores derived from the 24-month classifier into the full-follow-up gamma frailty Cox partial likelihood with sandwich variance correction. Random Forest was the best-performing classifier at the 24-month horizon (AUC = 0.750; sensitivity = 0.782; F1 = 0.810); PSA was the dominant predictor (14.2% mean Gini decrease), followed by BMI (11.8%), Stage T4 (9.6%), age (8.3%), and Gleason score (7.1%). For the full-follow-up survival endpoint, the Hybrid Cox-RF achieved a 10-fold cross-validated C-index of 0.743, compared with 0.671 for the standard Cox model (ΔC = +0.072; a 10.7% relative improvement), an AIC of 1364.21 (ΔAIC = 57.7 versus the next-best Extended Cox Frailty model), a Hosmer–Lemeshow p-value of 0.794, and a calibration slope of 0.97. Because classifier tuning and hybrid-model fitting were not incorporated into a fully nested cross-validation loop, these hybrid-model estimates should be interpreted as an internally cross-validated upper bound pending confirmation through external validation or nested cross-validation. The RF risk score was strongly associated with mortality (HR = 10.91 per 0.5-unit logit increase; 95% CI: 5.47–21.77); most clinical covariate hazard ratios remained stable (within ±15%) after its inclusion, the RF score absorbed the linear age effect, and rural residence remained independently significant (HR = 1.597, p = 0.008), indicating structural barriers to healthcare access beyond clinical severity. Pending external validation and nested cross-validation, the Hybrid Cox-RF framework is proposed as a candidate analytical approach for prostate cancer survival prediction in Ghanaian and comparable sub-Saharan African clinical settings, offering an interpretable artificial-intelligence approach that can support precision oncology and clinical decision-making in low-resource healthcare systems.

Testing the Proportional Hazards Assumption before Cox Model Application: A Three-test Sequential Protocol with Empirical Validation in a Ghanaian Prostate Cancer Cohort

2026-08-21T13:13:11+00:00

Background: Prostate cancer remains a leading cause of cancer mortality among men in Ghana and across sub-Saharan Africa, with many patients presenting at advanced disease stages where survival outcomes are influenced by disease progression, treatment failure, comorbidities, and sociodemographic factors.

Aim: To develop and empirically apply a three-test sequential protocol for diagnosing non-proportional hazards and latent heterogeneity before Cox model application, and to evaluate its impact on hazard-ratio interpretation in a Ghanaian prostate cancer cohort.

Study Design: Retrospective cohort study was undertaken.

Place and Duration of Study: The oncology unit of a Ghanaian tertiary referral hospital; the cohort comprised patients with a confirmed prostate cancer diagnosis and a minimum of three months’ post-diagnosis follow-up.

Methodology: Data from 200 patients with prostate cancer (161 prostate cancer deaths) were analysed. The three-test protocol integrated Schoenfeld residual tests, complementary log–log graphical diagnostics, and a boundary-corrected likelihood ratio test for gamma frailty variance. Four models were compared: the standard Cox model, the extended Cox model with time-varying coefficients, the Cox model with gamma frailty, and the extended Cox model with gamma frailty. Competing risks were assessed using the Aalen–Johansen cumulative incidence function. Model performance was evaluated using AIC, BIC, and 10-fold cross-validated concordance indices.

Results: The global Schoenfeld test rejected the PH assumption (χ²(15) = 33.67, p = 0.004), with age, rural residence, cancer stage, and hormonal therapy exhibiting significant time-varying effects. Graphical diagnostics confirmed stage-related non-proportionality, and a significant gamma frailty variance indicated residual unobserved heterogeneity. The extended Cox model with gamma frailty provided the best overall performance (AIC = 1421.89; cross-validated C-index = 0.701), outperforming the standard Cox model (AIC = 1438.63; C-index = 0.671). Competing risks had a negligible influence on the survival estimates.

Conclusion: The proposed sequential diagnostic protocol offers a systematic and reproducible approach to identifying non-proportional hazards and latent heterogeneity before final Cox model selection. Its application showed that conventional Cox regression may obscure clinically important time-dependent prognostic relationships in this cohort. The framework supports more appropriate model selection and may improve the validity and interpretability of survival analyses in prostate cancer and other biomedical applications.

The Peritoneal Paradox: Deciphering the Conflicting Evidence for HIPEC in Primary Versus Recurrent Ovarian Cancer

2026-06-05T12:24:04+00:00

Advanced-stage ovarian cancer is characterized by high mortality and frequent peritoneal recurrence. “Hyperthermic Intraperitoneal Chemotherapy” (HIPEC), which delivers heated chemotherapeutic agents directly into the peritoneal cavity following cytoreductive surgery (CRS), aims to enhance local cytotoxicity against microscopic residual disease. A comprehensive Boolean search was conducted using PubMed/Medline, Google Scholar, Embase and Scopus to identify relevant studies on the use of HIPEC for primary and recurrent ovarian cancer. Evidence from randomized controlled trials (RCTs) indicates that HIPEC significantly improves overall survival (OS) in primary advanced-stage disease, specifically when administered during interval debulking surgery (IDS) following neoadjuvant chemotherapy (NACT). Conversely, its role in primary debulking and recurrent settings remains controversial. While some trials show benefits, others, including the HORSE trial, found no significant difference in OS. Furthermore, HIPEC is associated with increased morbidity, including longer operative times and a higher incidence of grade 3-5 adverse events. Consequently, current guidelines primarily recommend HIPEC as an option for stage III patients during IDS. While a promising advance, further research is required to standardize protocols and optimize patient selection.

Emerging Technologies in Cancer Treatment: Advances in Gene Therapy, Immunotherapy, Nanomedicine, and Precision Oncology

2026-07-02T07:19:27+00:00

Cancer treatment has advanced substantially with the development of molecularly targeted and immune-based approaches that aim to improve therapeutic selectivity and reduce treatment-related toxicity. This review summarises selected emerging technologies in cancer treatment, including gene therapy, CRISPR/Cas9-based genome editing, cellular immunotherapy, immune checkpoint inhibition, cancer vaccines, oncolytic viruses, nanozyme-based approaches, nanomedicine, clinical sequencing, proteomics, and proteolysis-targeting chimeras. Gene therapy and genome-editing platforms provide opportunities to modify cancer-associated genetic alterations, although delivery efficiency, off-target effects, safety, and clinical translation remain important challenges. Chimeric antigen receptor T-cell therapy has shown substantial clinical value in selected haematological malignancies, whereas its application in solid tumours remains limited by antigen heterogeneity, poor trafficking, immune suppression, and toxicity. Immune checkpoint inhibitors and combination immunotherapy have improved outcomes in several cancers, but response rates vary across tumour types and patient groups. Nanomedicine and nanozyme-based systems may improve drug delivery, tumour targeting, imaging, and modulation of the tumour microenvironment, although many applications remain under preclinical or early clinical evaluation. Proteomic profiling, gene panel testing, and next-generation sequencing support biomarker discovery and precision oncology by identifying molecular alterations that may guide diagnosis, prognosis, and therapy selection. Proteolysis-targeting chimeras represent a developing strategy for the selective degradation of disease-associated proteins, including proteins that are difficult to inhibit using conventional approaches. Overall, these technologies are contributing to a shift towards more individualised and multimodal cancer care. Further validation, standardisation, safety assessment, cost consideration, and carefully designed clinical trials are required before many of these approaches can be widely implemented.

Phytochemical Modulation of T-Lymphocyte Responses in Cancer: Mechanisms, Evidence Gaps and Translational Priorities

2026-07-29T11:32:07+00:00

T lymphocytes are central effectors of tumour immunosurveillance and the principal cellular targets of several successful cancer immunotherapies. Their activity in solid tumours is nevertheless constrained by defective priming, exclusion from tumour nests, suppressive myeloid and regulatory T-cell populations, nutrient competition, chronic antigen exposure and progressive dysfunction. Phytochemicals are increasingly proposed as low-cost immunomodulatory adjuncts, yet the literature often conflates direct tumour cytotoxicity with restoration of T-cell immunity and frequently relies on exposure conditions that are difficult to reproduce clinically. This critical narrative review evaluates how chemically defined plant-derived compounds, selected standardised botanical preparations and microbiota-derived phytochemical metabolites influence anti-tumour T-cell responses. Literature published from 1 January 2000 to 25 May 2026 was selected through live searches of accessible scholarly sources, citation chaining and verification of article identity, relevance and Digital Object Identifiers. Evidence was synthesised around T-cell state, tumour-intrinsic immunogenicity, antigen presentation, myeloid suppression, checkpoint regulation, metabolism, memory formation and combination therapy. Curcuminoids, berberine, sulforaphane, flavonoids, ginsenosides, platycodins, shikonin, tetrandrine, caffeine and urolithin A provide mechanistically diverse preclinical signals. The strongest studies use immunocompetent models, immune-cell depletion or pathway perturbation to show T-cell dependence; weaker studies infer immune enhancement from infiltration, checkpoint expression or tumour shrinkage alone. Bidirectional effects are common: curcumin, resveratrol and shikonin can enhance selected anti-tumour pathways while suppressing T-cell activation under other conditions. Human evidence remains sparse. A phase I sulforaphane study reported peripheral myeloid and CD8 T-cell biomarker changes, but no phytochemical has yet shown replicated clinical improvement in T-cell-mediated tumour control or immunotherapy efficacy. Translation therefore requires exposure-matched mechanistic studies, standardised products, lineage-resolved immune endpoints, rational scheduling and biomarker-rich early trials. Phytochemicals should presently be regarded as experimental immunomodulators rather than established cancer immunotherapy adjuncts.

Modulating the Future Liver Remnant before Major Hepatectomy: A Critical Appraisal of the Comparative Effectiveness and Safety of Venous, Surgical, and Radiation-based Augmentation Strategies

2026-08-11T12:30:31+00:00

Major and extended hepatectomy remains the principal curative treatment for many primary and secondary hepatic malignancies, yet an inadequate future liver remnant (FLR) continues to preclude resection in a substantial proportion of patients and is the dominant determinant of post-hepatectomy liver failure (PHLF), the leading cause of perioperative death after extensive resection. Several strategies now compete to augment the remnant before surgery: percutaneous portal vein embolization (PVE), surgical portal vein ligation within a planned two-stage hepatectomy, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and its variants, combined portal and hepatic vein occlusion delivered as liver venous deprivation or double vein embolization, and radiation lobectomy achieved through unilobar transarterial radioembolization. This critical narrative review evaluates the comparative effectiveness and safety of these approaches rather than cataloguing them individually. Evidence was drawn primarily from indexed peer-reviewed literature identified through MEDLINE and complementary scholarly sources, with reference-level verification. The synthesis distinguishes what is well supported from what remains provisional. PVE is effective and safe but is limited by an interval dropout attributable to insufficient hypertrophy or interval tumour progression. ALPPS produces the most rapid volume gain and the highest resection rates, at the cost of higher, though now attenuated, perioperative risk. Combined venous deprivation achieves volume gains and growth kinetics approaching those of ALPPS through a percutaneous route, but high-quality comparative outcome data remain limited. Radiation lobectomy augments the remnant more slowly while adding local tumour control. A recurring problem is the dissociation between the volume a technique produces and the clinical benefit it confers, and the near-absence of randomised comparisons for the newer venous techniques. The review identifies priorities for adequately powered trials that report function alongside volume, oncological endpoints, and patient-centred outcomes, and argues that technique selection should be individualised to tumour biology, parenchymal quality, and institutional expertise rather than driven by volumetric performance alone.

Extent of Resection and Survival in Glioblastoma: Clinical and Pathological Correlates: A Systematic Review and Meta-Analysis

2026-05-29T07:31:55+00:00

Background: Glioblastoma is the most aggressive primary malignant brain tumor in adults and is associated with poor prognosis despite advances in surgical and adjuvant therapies. Extent of resection (EOR) has emerged as a critical prognostic factor influencing survival outcomes; however, the optimal degree of tumor removal and its relationship with clinical and pathological characteristics remain controversial.

Objective: To systematically evaluate the impact of extent of resection on overall survival (OS) and progression-free survival (PFS) in patients with glioblastoma and to assess associated clinical and pathological correlates.

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched for eligible studies published from 2000 to 2026. Studies comparing survival outcomes according to extent of resection, including gross total resection (GTR), subtotal resection (STR), supramarginal resection (SMR), and biopsy, were included. Data extraction and quality assessment were independently performed by two reviewers. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models, and heterogeneity was assessed using the I² statistic.

Results: A total of [number] studies involving [number] patients with glioblastoma were included. Compared with STR or biopsy, GTR was significantly associated with improved OS (pooled).

Systematic Review on Multiple Myeloma: Its Current Prevalence, Etiology, Pathophysiology, Clinical Features, Diagnostic Criteria, Staging Challenges, Management Strategies, Complications, and Prognostic Outcomes

2026-07-29T11:47:06+00:00

Background: Multiple myeloma (MM) is a complex and multifaceted hematological malignancy characterized by clonal proliferation of plasma cells in the bone marrow. This process may lead to bone destruction, anemia, hypercalcemia, renal impairment, variable relapsing and refractory patterns, and poor prognostic outcomes.

Objective: This comprehensive review aims to summarize the current understanding of multiple myeloma, including its epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis.

Methodology: A systematic search of peer-reviewed literature was conducted using multiple searches across ten search engines and databases, including PubMed, Scopus, and Web of Science. The search focused on recent studies on multiple myeloma published between 2020 and 2026. Relevant articles were selected and analyzed to provide an up-to-date summary of the disease. Of 488 articles screened, 330 were included in this review.

Results: MM accounts for approximately 1.8% of all new cancer cases and 10% of hematological cancers. Incidence increases with age, with a median age at diagnosis of 70 years. Pathogenesis involves genetic mutations, epigenetic alterations, and interactions with the bone marrow microenvironment. Common clinical presentations include bone pain, anemia, hypercalcemia, and renal impairment. Diagnosis relies on serum protein electrophoresis, bone marrow biopsy, and imaging studies. Treatment options include chemotherapy, proteasome inhibitors, monoclonal antibodies, and stem cell transplantation.

Main Findings: Despite advances in treatment, multiple myeloma remains challenging in its curability with a median overall survival of 5-7 years. However, recent therapeutic innovations have improved outcomes, and ongoing research aims to identify novel targets and strategies to overcome treatment resistance and relapses.

Conclusion: MM remains clinically complex despite therapeutic advances. Continued attention to diagnostic standardization, risk stratification, treatment sequencing, supportive care, and sex-stratified outcome reporting is required to improve evidence quality and patient-centered management.

Secondary Immune Thrombocytopenic Purpura Presenting as Severe Epistaxis Associated with Maxillary Sinus Malignancy: A Case Report

2026-06-04T13:38:11+00:00

Immune thrombocytopenic purpura (ITP) is an acquired autoimmune disorder characterised by isolated thrombocytopenia (platelet count <100 × 10⁹/L) and bleeding manifestations. While primary ITP is common, secondary ITP associated with solid organ malignancies is a rare and challenging clinical overlap. A 25-year-old male with a known history of immune thrombocytopenic purpura presented with severe recurrent epistaxis associated with facial swelling. Evaluation revealed thrombocytopenia without abnormalities in coagulation parameters, consistent with ITP. Due to persistent bleeding and atypical local symptoms. Imaging of the paranasal sinuses revealed a mass lesion involving the maxillary sinus, and histopathological examination confirmed malignancy. Early recognition of secondary causes of ITP can significantly influence treatment strategy and prognosis. This case emphasises the necessity of investigating secondary causes of thrombocytopenia when patients present with atypical local symptom that severe epistaxis may represent the initial manifestation of a complex interaction between haematological and malignant processes.