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Pediatric cancer outcomes have improved dramatically in high-income countries (HICs) with more than 80% of patients surviving. This has been achieved through early diagnosis, the formation of collaborative research groups, and government policies. selleck kinase inhibitor However, most children with cancer in low and middle-income countries (LMICs) do not survive due to multiple factors including lack of resources, manpower, and national level pediatric cancer policy. If we need to improve the overall outcome of children with cancer then we need to focus our attention on children in LMICs as they constitute 80% of the worldwide disease burden. This article looks at the burden of pediatric cancer, examines pediatric oncology policy paralysis, and offers possible solutions for improving care for children with cancer.Secretory carcinoma (SC) of the salivary gland is considered to be a low-intermediate grade tumor with the potential of locally aggressive behavior. This tumor is similar both genetically (ETV6-NTRK3 fusion) and histologically to secretory carcinoma of the breast. We intent to share our experience of four cases of SC in terms of clinical behavior, pathological features, and treatment outcome. Medical records of four cases of SC were retrieved and analyzed for clinical presentation, surgical treatment, and outcome. Pathological data was reanalyzed along with immunohistochemistry. Out of the four identified SC cases, three were men. Two lesions originated from the parotid gland and two from minor salivary glands. Two of these cases exhibited features of locally aggressive pattern. SC of salivary gland origin has distinct histological and immunohistochemical features apart from the characteristic genetic translocation and fusion. Surgery with or without adjuvant radiotherapy is the treatment of choice. To establish the biological behavior of this tumor, larger case series with long-term follow-up is desirable.The capacity to metastasize after long periods of discovery and resection of the primary renal lesion or to present as metastasis with undisclosed primary lesions grant renal cell carcinomas (RCC) a formidable and unpredictable behavior. We report three unusual cases of metastasis from RCC. The first patient presented with metastatic clear cell adenocarcinoma in the right shoulder muscles, with unknown primary and revealed an undetected clear cell right RCC on radiology. The second patient presented with a hemorrhagic nasal metastasis of RCC. A history of nephrectomy for RCC, 10 years prior to the development of nasal metastasis was elicited. The third patient presented with axillary and later abdominal wall metastasis of papillary RCC. He had a history of RCC 3 years prior to the discovery of metastasis. RCC has the propensity to appear as a metastatic carcinoma with unknown primary, requiring exclusion of several diagnostic pathologic entities. The appearance of metastasis many years after disease quiescence is challenging and clinicians need to be sensitized to the need for long-term surveillance in RCC. Though the prognosis remains poor, immune checkpoint inhibitors are currently the modalities of choice in such cases.
Coronavirus disease-2019 (COVID-19) causing a pandemic mostly results in mild symptoms; however, it can evolve into serious complications. It is emphasized that if the term from the recent anticancer treatment to the diagnosis of COVID-19 was short, the probability of serious events increased in cancer patients. Therefore, early detection of COVID-19 and prevention of serious events is very important. We aimed to investigate whether it is possible to detect COVID-19 early by positron emission tomography (PET)/computed tomography (CT).
We retrospectively evaluated the images and clinical findings of patients who underwent PET/CT due to malignancy and whose COVID-19 polymerase chain reaction (PCR) test were detected positive subsequently.
Eight cancer patients with positive COVID-19 PCR tests were included in the study. PET/CT revealed subpleural ground-glass opacities (GGOs) showing mild fluorodeoxyglucose (FDG) uptake that could be compatible with COVID-19 in 4 of 8 patients. The number of affected lobes ranged from 1-4. All patients were diagnosed with COVID-19 by PCR test when symptoms and/or lung findings worsened on the days after PET/CT. The time interval between the last anticancer treatment and COVID-19 diagnosis in five patients was ≤7 days. During the follow-up, six of the cases (75%) needed mechanical ventilation and died later.
COVID-19 may be recognised early by detecting incidental findings in PET/CT, especially in asymptomatic cancer patients. Potential complications may be prevented by early diagnosis and anticancer therapy changes. Therefore, possible COVID-19 findings in PET/CT should be reported and the patient should be referred to relevant clinician.
COVID-19 may be recognised early by detecting incidental findings in PET/CT, especially in asymptomatic cancer patients. Potential complications may be prevented by early diagnosis and anticancer therapy changes. Therefore, possible COVID-19 findings in PET/CT should be reported and the patient should be referred to relevant clinician.
Quality of life (QOL) is an important parameter to evaluate and modify in patients treated for cervical cancer as long-term survival is excellent in early-stage and reasonably good in locally advanced stage compared to other solid cancers. The aim of the study was the cross sectional evaluation of the quality of life in survivors completing at least 3 years of follow-up after curative therapy for cervical cancer at a tertiary cancer institute.
All patients, following primary curative treatment with no evidence of recurrence and completing at least 3 years follow-up, were assessed for QOL using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-30 and its cervical cancer module (Cx24). Patients were subdivided based on the modality of treatment. Analysis was done using Kruskal-Wallis and Mann-Whitney U test.
One hundred seven patients were analyzed out of the 113 patients initially included. Treated patients showed good global QOL (mean value 84.07) and functional scores (covering all domains).