Open Access Case study

Giant Fungating Cutaneous Myxoma of the Head and Neck: An Unusual Presentation

Aliyu Daniel, K. R. Iseh, J. H. Solomon, Olawole W. Olalekan, Braimah R. Oyebunmi, Ibikunle A. Aremu, Taiwo A. Olanrewaju, Sahabi S. Mallami, Adeyeye M. Folusho, Nazish P. Aquil, S. B. Amutta, M. Abdullahi, Okoro C. Joshua

Journal of Cancer and Tumor International, Page 1-5
DOI: 10.9734/jcti/2019/v9i430112

Introduction: Virchow first describes Myxomas in 1871; they are benign tumors of primitive indifferent mesenchyme that have preference for the cardiac muscles, genitourinary tract, gastrointestinal tract, liver and spleen. The rarity of the tumor, especially in the head and neck region makes us to report this case.

Case Report: A 16-year-old male secondary student who presented with a 9-year history of painless progressive submandibular swelling, no extension to the mouth. Examination revealed a huge fungating submandibular mass, 20 cm x 16 cm x10 cm in dimension, mobile, non-tender and firm in consistency. Other findings were unremarkable, and routine hematological and biochemical tests were all within normal limits. He subsequently had excision of the mass (weighs 950 g) under general anesthesia via an elective tracheostomy with split thickness skin grafting of the exposed strap muscles. Histopathological report revealed cutaneous myxoma.

Conclusion: Cutaneous myxoma of the Head and Neck region is presented for its rarity, and although is a histologically benign neoplasm, treatment is extremely challenging with high incidence of recurrence.

Open Access Case study

Glans Resurfacing in Carcinoma in situ of the Penis: A Case Report

Raquel Catarino, André Cardoso, Carlos Ferreira, Diogo Pereira, Tiago Correia, Manuel Cerqueira, Frederico Carmo Reis, João Correia-Pinto, Raquel Crisóstomo, Maria João Gama, Rui Prisco

Journal of Cancer and Tumor International, Page 1-5
DOI: 10.9734/jcti/2019/v9i430113

Aims: Penile cancer is an uncommon malignancy in Western countries. There are known premalignant lesions that can progress to invasive penile cancer, namely carcinoma in situ (CIS) of the glans. Treatment options for this disease include topical chemotherapy and laser ablation, but the published literature demonstrates limited efficacy for these approaches. Surgical techniques with penile-preserving approaches are performed with the goal of removing the entire tumor and preserving as much of penis as possible. There are no large, randomized studies comparing treatment options for these lesions, and reports concerning the surgical approaches are scarce.

Presentation of Case: In this study, we present a case report of a patient with CIS of the glans penis surgically treated with glans resurfacing.

Discussion and Conclusions: There were no complications during follow-up, and after 20 months, the patient has no evidence of disease recurrence, has preserved urinary and erectile functions and is currently satisfied with the cosmetic appearance.

CIS treatment with glans resurfacing allows the maintenance penile length and function with a good aesthetic result without compromising oncologic control. This approach also allows an accurate staging of the disease and assessment of the treatment efficacy.

Open Access Original Research Article

Four Facets to Know a Cancer Care-related Journal: An Example of Eur. J. Cancer Care (Engl.)

Wan-Ting Hsieh, Tsair-Wei Chien, Willy Chou

Journal of Cancer and Tumor International, Page 1-9
DOI: 10.9734/jcti/2019/v9i430114

Objective: This study aimed to investigate the journal features by collecting some data from Pubmed Central (PMC) and to interpret the characteristics of the journal for Eur J Cancer Care (Engl) (EJCC).

Methods: Selecting 1611 abstracts and their corresponding author names and keywords on September 3, 2017, from PMC, we analyzed data mentioned above to address following features: (1) Nation distribution and author collaborations; (2) Journal features represented by article keywords; (3) The most productive authors and their authorship clusters; (4) The top 10 journals most similar to EJCC. Microsoft Excel VBA routines were programmed to extract data from PMC. Rasch model and SNA Pajek software were used to present visualized displays for EJCC features.

Results: We found (1) the majority of the articles are from UK (28%) Australia (10%) and Sweden (5%); (2) The most linked Keywords are cancer and breast cancer; (3) The most productive author is R Sanson-Fisher; (4) The top one journal with the most similarity to EJCC is Support Care Cancer.

Conclusion: Social network analysis that provides wide and deep insight into the relationships among nations, coauthor collaborations, abstract keywords and journals most similar to EJCC was performed in this study. The results can be provided to strategy and decision making for the target journal in the future.

Open Access Original Research Article

Can G8 Scoring in Patients with Geriatric Lung Cancer Help to Determine Curative Treatment?

Şule Karabulut Gül, Hüseyin Tepetam

Journal of Cancer and Tumor International, Page 1-7
DOI: 10.9734/jcti/2019/v9i430115

Objective: The median age at diagnosis of lung cancer is 70 years and there are limited data in the literature regarding the treatment of elderly patients. In elderly patients, comorbid diseases, poor performance, and toxicity may lead to a surge in physicians' curative treatment and may remain untreated. The aim of this study was to evaluate the results of treatment in patients older than 70 years whose performances were evaluated by using Geriatric 8 score and to find out the response to curative treatment.

Materials and Methods: 124 patients over 70 years of age were evaluated retrospectively. 68 patients with early stage or locally advanced non-small cell lung cancer who were inoperable but not suitable for stereotactic radiotherapy were evaluated retrospectively. Geriatric 8 (G8) screening test was used to identify elderly cancer patients who could benefit from curative treatment. Patients received curative chemoradiotherapy or radiotherapy alone.

Results: In all patients (68), overall survival (83% for 1 year, 66% for 2 years) was median 18 months and disease free survival (58% for 1 year, 34.1% for 2 years) was median 14 months. As the G8 score increased, a statistically significant increase was observed in overall and disease free survival. Having weight loss or not, presence of accompanying disease, having good or bad health situation, having body mass index above and below 21, and the usage number of medications below or above 3 affects overall and disease free survival. When only the patients who received radiochemotherapy (n = 43) were evaluated, the mean survival (free of the ECOG performance score) was 12.8 months with G8 score less than 14 and 29.17 months with G8 score 14 and above and were statistically significant (p = 0.000).

Conclusion: When making a treatment decision, clinical evaluation should be performed well in patients older than 70 years with non-small cell lung cancer (NSCLC). In our study, overall survival and disease free survival were found to be better in patients with a G8 score above 14. Therefore, we think that it may be appropriate to use curative concurrent radio chemotherapy in selected patients with high G8 score and not to decide on biological age in elderly patients.

Open Access Original Research Article

Dose-volumetric Predictors for Thyroid Dysfunction after 3D Conformal Radiotherapy: An Observational, Prospective Study

M. Al-Jamal, A. Abd Elnaby, A. El-Badrawy, H. M. H. R. Elkalla, R. Omar, E. Abdallah

Journal of Cancer and Tumor International, Page 1-12
DOI: 10.9734/jcti/2019/v9i430116

Aim: This study was conducted to assess the dose-volumetric threshold of radiation induced hypothyroidism (RIHT) in patients receiving radiotherapy (RT) to the neck.

Study Design: This is a prospective cohort observational study.

Place and Duration of the Study: The study was conducted at Mansoura University Hospital, Mansoura, Egypt, between April 2016 until March 2019.

Methods: We have completed 2 years of follow up to 50 patients with different malignancies who were treated by radiotherapy to the neck. Baseline assessment of the thyroid clinically and radiologically was done prior to the start of radiotherapy. Periodic testing of the cohort through the follow up period was done by clinical examination, measurement of TSH, fT4 and thyroid ultrasonography.

Results: the incidence of RIHT was 26%. No statistical significance for the clinical risk factors. The dose-volumetric risk factors were studied and showed positive results. A mean dose of 5185 cGy was found a significant risk factor. Also, V40 ≥ 89%, V45 ≥ 63.5%, V50 ≥ 22.5% were found to be the cutoff predictors for the threshold radiation dose to induce hypothyroidism. Also decreasing the size of the gland by ≥0.7 cm3, fT4 value by ≥ 3.5 pmol/L and TSH by ≥ 0.75 uIU/L after one year from the end of EBRT is the cutoff value for prediction of occurrence of RIHT within the 2nd year of follow up.

Conclusion: RIHT is a considerable late adverse effect for patients receiving RT to the neck. Mean dose, V40, V45 and V50 were found significantly related to RIHT. Mean dose of ≥ 5185 cGy, V40 ≥ 89%, V45 ≥ 63.5%, V50≥ 22.5% were proven to be the dose-volumetric threshold.