Open Access Case study

Medullary Thyroid Carcinoma Metastatic to the Breast: Case Report

Amal Halim, Eman M. Ibrahim, Fatma I. El-saeed, Enas A. Abd Elgalil, Hosam Halim

Journal of Cancer and Tumor International, Page 1-6
DOI: 10.9734/jcti/2019/v9i330109

Aims: To spot the light on metastatic tumors to the breast which represent only 0.5-1.5% of breast malignancies to avoid misdiagnosis as primary breast tumors. 

Presentation of the Case: 45-year-old female was referred to the Oncology Department of Meet Ghmmr Oncology Center in November 2017 after total thyroidectomy followed by cervical lymph node dissection for medullary thyroid carcinoma (MTC) 1 year ago at Oncology Center Mansoura University. The panel recommended postoperative radiotherapy. One month after the end of radiotherapy, she complained of frequent headache attacks and abdominal pain. CT was done in February 2018 revealed metastasis to the brain, lung, liver and ovaries. After the fifth cycle of chemotherapy, a progressively enlarging left breast mass appeared, that proved to be metastatic MTC.

Discussion: MTC is a neuroendocrine tumor of the thyroid gland. Breast is an unusual metastatic site for MTC. Consequently, breast masses should be evaluated with caution, especially in the presence of a known primary malignancy. Histopathologic examination is the key diagnostic tool.

Conclusion: Metastasis to the breast should be considered in the differential diagnosis of a breast mass in a patient with a past history of MTC. Histopathologic examination and proper panel of immunohistochemical markers are fundamental for diagnosis to prevent unneeded surgery.

Open Access Original Research Article

Body Mass Index and Age Correlation with Prostate-specific Antigen Density as Prostate Cancer Risk Indicators in a Screened Male University Population in Nigeria: A Pilot Study

Eyam Sunday Eyam, Ima-Abasi E. Bassey, Edoise M. Isiwele, Eyam Lilian Eberechukwu

Journal of Cancer and Tumor International, Page 1-7
DOI: 10.9734/jcti/2019/v9i330107

Background: Prostate-specific antigen density (PSAD) is one of the means of improving PSA sensitivity as a marker of a prostate cancer diagnosis. However, this ability is perceived to be obscured by certain factors such as high body mass index and age in Caucasian and western populations, which tends to reduce its sensitivity and lead to misclassification of at-risk patients for prostate cancer.

Aim: We studied the correlation of body mass index (BMI) and age with prostate-specific antigen density (PSAD) as indicators of prostate cancer risk in a screened male population(40 years and above) in the University of Calabar, Nigeria.

Study Design: A cross-sectional analytical study with consecutive participant recruitment.

Place and Duration of Study: The study was carried out in the University of Calabar Medical centre during a medical outreach.

Materials and Methods: The study involved sixty-one (61) healthy male participants. BMI was mathematically determined from the weight and height and was categorized as underweight, normal weight, overweight and obesity based on the WHO classification with values of <18.5, 18.5-24.9, 25.0-29.9, and ≥30 (Kg/m2) respectively. Blood samples were collected and analyzed for PSA and transrectal ultrasound scan was done to estimate the prostate volume and was used to calculate the prostate-specific antigen density.

Results: Over 67% of participants had PSA values below 4.0 ng/ml, 14.8% between 4.0-10.0 ng/ml, and 18% above 10.0 ng/ml. Body mass index (BMI) assessment revealed that 1.6% of the sampled population had BMI <18.5 Kg/m2, 32.8% had BMI between 18.5 Kg/m2 and 24.9 Kg/m2, while 50.8% were noticed to have a BMI of between 25.0 Kg/m2 and 29.9 Kg/m2, and 14.8% had BMI of 30 Kg/m2 and above.

Conclusion: There was an inverse correlation of BMI with prostate-specific antigen density (PSAD) and a direct correlation of age with PSAD in this study of Nigerian men.

Open Access Original Research Article

Assessment of Quality of Life of Cervical Cancer Patients Using ECOG-Performance Status Scale

Shubham Lingappanoor, Geetha Rani Manupati, Vasthalya Meesala, Padma Yaragani, Brahmani Bachu, Shyam Sunder Anchuri

Journal of Cancer and Tumor International, Page 1-8
DOI: 10.9734/jcti/2019/v9i330108

Background: Cervical cancer is becoming one of the emerging health burdens for womenhood and India accounts for one-third of the cervical cancer deaths globally. More than 80% of women with cervical cancer are diagnosed at an advanced stage. In this study, we aimed to assess the Quality of Life (QOL) of patients with cervical cancer after treatment and to examine the factors affecting their QOL.

Materials and Methods: This is a retrospective observational study, included 218 cervical cancer patients. The study was conducted in a tertiary care hospital in Warangal of Telangana State. The impact of socioeconomic factors and clinical factors on the QOL of the patients were studied using Eastern Cooperative Oncology Group-Performance status (ECOG-PS) scale. The protocol was approved by KIEC-KMC, Warangal. The statistical analysis was performed by using Fischer's Exact test, a value of p<.05 was considered as significant.

Results: Out of 218 patients 189 were alive and 29 were deceased. Patient of age group 21-40 years, patients from urban areas, from upper socioeconomic status (SES), patients with literacy, without any social habits had good QOL, where as patients in labour forces had poor QOL and are statistically significant. Patients with early stage at diagnosis and patients underwent surgical treatment along with chemoradiation therapy had good QOL yet, these results are statistically insignificant.

Conclusion: The lack of access to preventive and definitive care by the health care sectors, poor socioeconomic status, educational status of the women and awareness regarding the disease and its treatment patterns resulted in poor follow up, low adherence to the treatment, which accentuated the cervical cancer burden. Hence, enhancing the above listed factors could be beneficial in improving QOL of cervical cancer patients.

Open Access Original Research Article

Uterine Carcinosarcomas versus Leiomyosarcomas: DuaL Institutional Experience from Mansoura and Zagazig Universities

Amal Halim, Niveen Abo-Touk, Nahla Mokhtar, Hadeel Elghamery, Eman Ismail, Amany Hassan, Hosam Halim

Journal of Cancer and Tumor International, Page 1-10
DOI: 10.9734/jcti/2019/v9i330110

Objective: Carcinosarcomas (CSs) and leiomyosarcomas (LMSs) are rare uterine cancers with high mortality. This study presents a dual institutional experience from two different university teaching hospitals (Mansoura and Zagazig Universities situated in the Delta of the Nile River in Egypt) with regard to the treatment modalities of those two types of uterine cancers aimed at establishing demographics and treatment outcomes.

Patients & Methods: The data from 12 uterine CS and 17 LMS patients treated at the Clinical Oncology Departments of Mansoura and Zagazig Universities from January 2012 to June 2018 were reviewed to evaluate demographics and treatment outcomes.

Results: The mean age of the patients was greater than 50 years. Abnormal uterine bleeding (AUB) was the most common presenting symptom.

Six CS (50%) patients underwent comprehensive surgical staging, while 4 patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH&BSO). Conversely, TAH&BSO was performed in 15 patients with LMS (88%).

Adjuvant radiotherapy was given to 6 CS (50%) and 4 LMS (24%) patients. Meanwhile, adjuvant chemotherapy was received by 5 CS (42%) and 8 LMS (47%) patients. Pelvic failure occurred in only the LMS group. Visceral metastasis occurred in both groups, while bone metastasis was encountered in only the CS group. The overall survival at 5 years was 53% and 32% in patients with CS and LMS, respectively.

Conclusion: AUB should be seriously investigated. Both diseases are aggressive despite early presentation and radical multimodality treatment. Local recurrence was reported in only the LMS group. Visceral metastasis occurred in both groups, unlike bone metastasis. New targeted therapies are urgently needed.

Open Access Original Research Article

Reduced P53 Protein Level and Evidence of Ongoing Coagulation among HIV-Infected Persons Accessing Treatment at University of Calabar Teaching Hospital, Nigeria

E. C. Akwiwu, A. O. Okafor, J. O. Akpotuzor, E. E. Onukak

Journal of Cancer and Tumor International, Page 1-6
DOI: 10.9734/jcti/2019/v9i330111

Aims: To assess tumour suppressing activity and ongoing coagulation among persons living with HIV infection and accessing care in the University of Calabar Teaching Hospital, Nigeria.

Study Design: Case-control study.

Place and Duration of Study: University of Calabar Teaching Hospital Calabar, Nigeria, between April 2018 and November 2018.

Methods: Ninety persons living with HIV infection who were attending clinics at the University of Calabar Teaching Hospital were enrolled with ninety age and sex-matched HIV seronegative individuals who served as control subjects. The blood specimen was collected from each participant for analyses of CD4 cell and full blood counts by automation, serum was used for the assays of P53 protein and D-dimer levels using enzyme-linked immunosorbent assay test kits. Data analysis was done using SPSS version 22.0. Student t-test was used to compare means between test and control subjects. One-way analysis of variance was used to compare means across the HAART-naïve and two other groups on different HAART protocols. Statistical significance was drawn at a p≤ 0.05.

Results: The CD4 cell count and P53 protein level reduced while D-dimer level increased in HIV infection. Platelet count also reduced while platelet distribution width increased with the condition. While CD4 cell count improved with Highly Active Antiretroviral Therapy administration, D-dimer level, mean platelet volume and platelet distribution width reduced.

Conclusion: This study observed reduced tumour suppression and increased coagulation activities alongside immunosuppression in HIV infection.