{"title":"Skin Metastasis in Breast Cancer Patients; a Case Series.","authors":"Sara Rehman, Muhammad Atif Naveed","doi":"10.37029/jcas.v6i1.307","DOIUrl":"https://doi.org/10.37029/jcas.v6i1.307","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is the most common malignancy in women. It frequently metastasizes to bones, lungs and liver. Although rare, skin metastasis may also take place. It may also be the presenting feature of initial or recurrent breast cancer. The assessment of recurrent metastatic disease involving skin after mastectomy can be challenging because of the benign-appearing clinical presentation. The purpose of this case series was to explore the clinical and radiological presentation of skin metastasis in patients of breast cancer.</p><p><strong>Materials and methods: </strong>This is a retrospective case series of breast cancer patients with skin lesions on chest and abdomen at the time of initial presentation, or post-treatment such as, after mastectomy or breast conservation therapy; who underwent various radiological investigations including mammography, ultrasound scan, computed tomography (CT) scan and magnetic resonance imaging from 1 May 2018 to 30 September 2019 at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan.</p><p><strong>Results: </strong>A total of eight cases were identified, out of which seven were females. The most common presentation consisted of the presence of metastatic nodules which were seen in 62.5% (five out of eight) of the patients. Other features consisted of erythematous or plaque-like skin thickening on clinical examination, increased density with indistinct margins seen on a mammogram and diffuse oedematous changes in the skin with small irregular mass or infiltration into subcutaneous tissues were visualised on ultrasound and CT studies.</p><p><strong>Conclusion: </strong>Skin metastasis from breast cancer most commonly presents as nodules, although rarely they may present as plaques or diffuse skin thickening. Awareness of diverse manifestations of skin metastasis is of utmost importance in early diagnosis and management.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"6 1","pages":"307"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.37029/jcas.v6i1.307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Khan, A. Malik, S. Mohtasham, A. Khan, M. Parvaiz, A. Loya
{"title":"THE ROLE OF INTRAOPERATIVE FROZEN SECTION OF SENTINEL LYMPH NODES IN UPFRONT BREAST CONSERVATION CANCER SURGERY","authors":"R. Khan, A. Malik, S. Mohtasham, A. Khan, M. Parvaiz, A. Loya","doi":"10.37029/JCAS.V5I2.227","DOIUrl":"https://doi.org/10.37029/JCAS.V5I2.227","url":null,"abstract":"Objective: Sentinel lymph node biopsy is the standard of care in clinically negative axilla in breast cancer patients for which frozen section (FS) is routinely performed intraoperatively. The objective of this study was to justify the use of FS in terms of number of tests performed and their impact on decision-making and cost saving. Materials and Methods: We retrospectively reviewed our prospectively maintained data from January 2014 to January 2018 for intraoperative FS in upfront breast conservation surgery patients. Results: A total of 357 patients were studied. All were female. Median age was 50 years (24–84). Mean tumour size was 29.11 mm. Numbers of sentinel lymph nodes identified were 1 in 50 (14.2%) patients, 2 in 121 (33.89%) patients and ≥3 in 186 (52%) patients. Number of positive sentinel lymph nodes was 0 in 264 (73.9%) patients, 1 in 62 (17.4%) patients, 2 in 20 (5.6%) patients and ≥3 in 11 (3.08%) patients. Axillary lymph node dissection (ALND) was offered to 30 (8.4%) patients as per the American College of Surgeons Oncology Group Z0011. The results for ALND showed that only 8 (2.3%) out of 30 patients had positive nodes identified in the additional axillary nodes dissected. Sensitivity of FS was 97% and specificity was 98.86%. False-negative rate was 3.22%. Conclusion: Intraoperative FS can be safely omitted in early breast cancer patients undergoing upfront breast conservation cancer surgery due to high sensitivity and specificity leading to low false-negative rates. ALND can be performed as a second operation as warranted only in a minority of patients. Key words: American College of Surgeons Oncology Group Z0011 trial, axillary lymph node dissection, intraoperative frozen section, sentinel lymph node biopsy","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"188 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78326658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"SOLITARY FIBROUS TUMOR OF BREAST","authors":"S. Noor, N. Akhtar, Usman Hassan, M. Hameed","doi":"10.37029/JCAS.V5I2.231","DOIUrl":"https://doi.org/10.37029/JCAS.V5I2.231","url":null,"abstract":"Solitary fibrous tumours (SFTs) are fibroblastic mesenchymal tumour primarily identified in the pleura but are now being reported in other anatomic sites as well. SFT is generally characterised as a radiologically confined neoplasm composed of a proliferated spindle cells arranged in patternless manner. Intervening tissue shows prominent haemangiopericytoma-like vessels. Stroma is usually fibrous. Tumour is positive for CD34. SFT has a specific translocation representing fusion NAB2 with STAT6 genes. This translocation can be highlighted with very good specificity and sensitivity using STAT6 immunohistochemical stain. Some cases of SFTs have also been described in the breast. Rarely, SFT can show aggressive behaviour. SFT enters the differential diagnoses of benign and malignant spindle cell tumours of breast and it is, therefore, important that its clinical, radiological and pathological features are known to clinicians and diagnosticians. Key words: CD34, myofibroblastoma, NAB2-STAT6, solitary fibrous tumour","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83647956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Taimoor Ali Tariq, Pir Abdul Ahad Aziz Qureshi, Muhammad Talha Yaseen Kaimkhani
{"title":"RUPTURED INTRACRANIAL DERMOID CYST","authors":"Taimoor Ali Tariq, Pir Abdul Ahad Aziz Qureshi, Muhammad Talha Yaseen Kaimkhani","doi":"10.37029/JCAS.V5I2.223","DOIUrl":"https://doi.org/10.37029/JCAS.V5I2.223","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80578915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"EWING’S SARCOMA: APPROACHING CENTURY SINCE THIS BONE CANCER MADE NEWS","authors":"Z. Fadoo, Mir Ibrahim Sajid","doi":"10.37029/JCAS.V5I2.263","DOIUrl":"https://doi.org/10.37029/JCAS.V5I2.263","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90160599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CENTRAL NERVOUS SYSTEM RELAPSE OF MULTIPLE MYELOMA","authors":"M. Qubtia, M. Nasir, Memoona Mian, A. Hameed","doi":"10.37029/JCAS.V5I1.199","DOIUrl":"https://doi.org/10.37029/JCAS.V5I1.199","url":null,"abstract":"Multiple myeloma (MM) is a plasma cell disorder primarily involving bone marrow. Extramedullary involvement is less common, with central nervous system (CNS) myelomatosis being a rare entity and such presentation carries extremely dismal prognosis. We present case of a 40 years old male with MM who was initially treated with 6 cycles of Cyclophosphamide, Thalidomide and Dexamethasone resulting in complete response. 2 years later he presented with CNS myelomatosis and scrotal involvement and was initially treated with Bortezomib and dexamethasone, cranial irradiation and intrathecal Methorexate, Cytarabine, Hydrocortisone (TRIO IT), along with radical orchiectomy and testicular radiation during the course of treatment. However, after initial response his disease showed clinical and radiological progression after 4 months of therapy. He was switched to high dose Methotrexate (HD-MTX) with TRIOITand later Lenalidamide and dexamethasone (Len/dex) was added to the above regimen. He continued to show good clinical response but his cytology remained persistently positive, therefore, HD-MTX was discontinued in the later course of treatment. Subsequently he was started on best supportive care only, when his neurological status deteriorated further. He survived almost 9 months after a diagnosis of CNS myelomatosis. Patients with multiple myeloma, presenting with neurological symptoms should always be investigated for the possibility of CNS MM. CNS relapse is a fatal disease with poor prognosis. Recommended treatment must include a systemic anti-MM regimen that crosses the BBB (ideally Immunomodulatory drugs (IMiDs) IMiDs-dexamethasone based therapy), CNS irradiation and intrathecal chemotherapy.Key words: Multiple myeloma, central nervous system myelomatosis, therapy","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91298430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"HEAD AND NECK CANCER STEM CELL PROTEOMICS","authors":"S. Saleem, Sahrish Tariq","doi":"10.37029/JCAS.V5I1.182","DOIUrl":"https://doi.org/10.37029/JCAS.V5I1.182","url":null,"abstract":"It is critical to identify the cell of origin of cancer and the genes/proteins/transcriptional/epigenetic factors of that cell. Here, we review studies on head and neck cancer stem cells (CSC) in the hope of developing better understanding of their role highlighting their importance as novel drug targets. CSC model has introduced a hierarchical conceptual framework for the interpretation of intratumour heterogeneity within tumour. This, in turn, has culminated in a major paradigm shift in terms of how different types of cancers can be targeted for treatment. Several malignancies conform to the CSC model of tumour growth yet identification of CSC markers remains a profound challenge.Key words: Chemo- and radio-resistance, head and neck cancer stem cells, proteomics, treatment modalities","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72732666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PERSISTENT LEFT SUPERIOR VENA CAVA: A DECEPTIVE ANOMALY","authors":"J. Aleem, W. Ahmad","doi":"10.37029/JCAS.V5I1.207","DOIUrl":"https://doi.org/10.37029/JCAS.V5I1.207","url":null,"abstract":"Persistent left superior vena cava (SVC) is a rare but vital congenital anomaly of the thoracic venous system. It is the persistence of vessel that normally regresses during early foetal life. It has utmost importance in intervention radiology, cardiothoracic procedures and insertion of the central venous line as well as in trauma. The vessel can drain into the right atrium through the coronary sinus, directly into left atrium or through pulmonary veins. It is usually detected during routine investigations and requires surgical treatment. In our case, SVC persists on both right and left sides with enlarged coronary sinus incidentally detected during follow-up for breast cancer.Key words: Persistent left superior vena cava, superior vena cava, vascular variant","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74065586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"THE PREVALENCE OF DYSPLASIA IN COLORECTAL SERRATED/HYPERPLASTIC POLYPS IN OMANI POPULATION","authors":"A. Qureshi, Nawras Al Hadi, A. Shalaby","doi":"10.37029/JCAS.V5I1.210","DOIUrl":"https://doi.org/10.37029/JCAS.V5I1.210","url":null,"abstract":"Purpose: Serrated/hyperplastic polyps (SPs) are characterised histologically by sawtooth architecture. Historically, these polyps were considered benign, without malignant potential and thus clinically unimportant. At present, the WHO defines serrated/hyperplastic lesions as heterogeneous group, which include hyperplastic polyps (HP), sessile serrated adenoma (SSA)/polyp and traditional serrated adenoma (TSA). These can have malignant potential. The aim of this study was to evaluate the prevalence of dysplastic changes in SP of colon and rectum of Omani population reported at a tertiary care centre.Methods: The study was conducted in the pathology department of a tertiary care centre including endoscopic polypectomies from colon and rectum of Omani patients presenting to gastroenterology clinic reported between 2014 and 2016, and these were analysed retrospectively for dysplastic changes and their association with different clinical parameters.Results: Dysplasia was seen in 32 of 146 cases (21.9%) and 114 (78.1%) were without dysplasia. Of these dysplastic, biopsies’ only two cases (1.4%) showed high-grade dysplasia and rest 30 (20.5%) low-grade dysplasia. According to the type of polyp, dysplasia was found in TSA 8/21 cases (46.7%) and SSA 9/17 cases (53.3%). Association of dysplasia was more common in the age group of > 50 (15.07%) and male patients (62.5%).Conclusion: SPs are now common findings that a gastroenterologist faces in their daily practice. In our study of Omani population, the prevalence of dysplasia is associated with older age group, male gender, SSA/polyp and traditional serrated adenoma.Key words: Dysplasia. colorectal, polyps","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82318632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MOST CANCERS ARE CAUSED BY BAD LUCK MUTATIONS: SCIENTIFIC EXPLANATION?","authors":"S. Pervez","doi":"10.37029/JCAS.V5I1.229","DOIUrl":"https://doi.org/10.37029/JCAS.V5I1.229","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72554929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}