Adjuvant radiotherapy in the management of porocarcinoma with lymphatic micrometastasis

Background. Porocarcinoma is a rare skin tumor originating from dermal sweat glands. Surgical procedures are the first choice of treatment, but the role of adjuvant therapies, such as chemotherapy and radiotherapy (RT), is not clear. In this case report and review of the literature, we aimed to present a patient who underwent adjuvant RT for the diagnosis of porocarcinoma with lymphatic micrometastasis and a review of the current literature.  Case summary. A 61-year-old male was admitted to the dermatology department for a nodular lesion on the left knee skin. An excisional biopsy was performed, and the pathology result was reported as porocarcinoma. The closest surgical margin of the tumor was 0.2 cm. In the inguinal sentinel lymph node sampling, two of the three removed lymph nodes had micrometastases. Then, adjuvant RT was applied to the left inguinofemoral lymphatics and primary tumor bed. No recurrence was observed in the patient with a follow-up period of 24 months. No acute or late toxicity was observed including lymphedema, subcutaneous fibrosis, or stiffness of the knee joint. Conclusions. Although adjuvant RT is not a routinely recommended treatment, it can be applied to increase local and regional control in patients with high-risk factors for recurrence or with lymph node metastases. There is a great need for clinical studies clarifying the role of RT, but for now, all patients should undergo multidisciplinary evaluation when a decision on adjuvant therapies is made

Critical Role Of Ga-68 Dotatate Pet-Ct In A Patient With Neuroendocrine Tumor And Second Primary Cancer

A 70-year-old female with the diagnosis of the metastatic neuroendocrine tumor was referred to our clinic with new abdominal lymph nodes in computed tomography (CT). This finding was considered as the disease progression, and capecitabine along with temozolomide was added to her current lanreotide therapy. The origin of the new lymph nodes was uncertain due to no response to chemotherapy and the stability of the lymph nodes. Ga-68-DOTATATE PET-CT was performed to resolve the inconsistency in clinical and imaging findings. PET-CT images showed high Ga-68-DOTATATE uptake in abdominal, cervical, left supraclavicular lymph nodes, and few metastatic foci in the liver, which were compatible with a neuroendocrine tumor. Additionally, there were bilaterally enlarged lymph nodes in the neck, axillary, intra-abdominal and inguinal area with no tracer uptake. The incongruent findings of PET-CT suggested a biopsy of nonradio-avid lymph nodes for the possible exclusion of other etiologies. Biopsy revealed that the enlargement of the lymph nodes was caused by small lymphocytic lymphoma (SLL) rather than neuroendocrine metastases. Ga-68-DOTATATE PET-CT led to a critical change in the disease management and confirmed the diagnosis of the secondary tumor with the aid of biopsy. A high radiotracer uptake of neuroendocrine metastases on Ga-68 DOTATATE PET-CT suggested to change the chemotherapy (capecitabine+ temozolomide) to Y-90/Lu-177 DOTATATE therapy, which led to disease stabilization and minor regression. Her newly diagnosed stable SLL was followed accordingly. It can be concluded that Ga-68 DOTATATE PET-CT plays a critical role in the management of patients with neuroendocrine tumors and should be used as a problem solving tool in patients with the discrepancy between clinical and imaging findings.WoSScopu

Lack of Association Between the Mthfr C677T Polymorphism and Lung Cancer in a Turkish Population

Background: In this case-control study, we aimed to investigate the relationship between the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and lung cancer. Materials and Methods: Total 200 individuals including 100 patients with lung cancer and 100 controls were analyzed. Genotyping of MTHFR C677T was performed using PCR and RFLP methods. Results: The majority of the patients were men and 90% were smokers. We found that the risk ratio for development of LC was 13-times higher in smokers compared with non-smokers between patient and control groups in our study (OR:13.5, 95% CI:6.27-29.04, p:0.0001). Besides, the risk ratio for development of LC was nine times higher in individuals with cancer history in their family than those without cancer history (OR:9.65, 95% CI:2.79-33.36; p:0.0001). When genotype distributions and allele frequencies were analyzed in the study groups, no significant difference was apparent (chi(2):0.53, p=0.76). In addition, no correlation between genotypes of MTHFR C677T polymorphism and histological type of LC was found (chi(2):0.99, p=0.60). Conclusions: These results suggest that there was no association between the MTHFR C677T polymorphism and lung cancer in the Turkish population.WoSScopu

Screening Colonoscopy Participation In Turkish Colorectal Cancer Patients and Their First Degree Relatives

Background: This study aimed to research the awareness of screening colonoscopy (SC) among patients with colorectal cancer (CRC) and their relatives. Methodology: A questionnaire form including information and behavior about colonoscopic screening for CRCs of patients and their first-degree relatives (FDRs) was prepared. Results: A total of 406 CRC patients were enrolled into the study, with 1534 FDRs (siblings n: 1381 and parents n: 153). Positive family history for CRC was found in 12% of the study population. Previous SC was performed in 11% of patients with CRC. Mean age of the patients whose FDRs underwent SC was lower than the patients whose FDRs did not (52 vs 57 years; p<0,001). The frequency of SC in FDRs was 64% in patients diagnosed CRC under 35 years of age. Persons having a positive family history of CRC had SC more often (51 vs 22%, p<0,001). FDRs of patients having a higher educational level and income had SC more frequently. Conclusions: When screening for CRC is planned, elderly subjects, those with family history for CRC, and those with low educational and lower income should be given esspecial attention in order that they be convinced to undergo screening for CRC.WoSScopu

Reproductive cancer risk factors among relatives of cancer patients in a tertiary oncology center

Abstract Background The aim of this study was to evaluate the prevalence of some gynecological cancer risk factors in a population of female relatives of cancer patients in Hacettepe University Oncology Hospital. Additionally, what are the levels of the women’s awareness /behavior toward available screening tools? Methods An individual cancer risk assessment questionnaire has been developed in the Department of Preventive Oncology, which questions the medical history, health behaviors and cancer awareness, as well as their behavior toward available cancer screening tools. Results The mean age of the study population was 45.7 ± 12.2 years. Median age at menarche was 13 years (IQR, 12–14), 6.9% of the women reported their menarche was before age of 12. About 11.1% of the women had intercourse before age of 18. The median age at first delivery was 22 years. Median BMI was 24.9, with 18.3% of population having obesity. Of the women 65% were current/past smokers. Sixty-two percent of the women had never used condom. About 8% of the women were unaware about mammography and 17.7% about the Pap test. Conclusions This study has documented high tobacco use, low protective condom use and low rates of physical activity. Percentage of some risk factors like early menarche was lower than what was suggested for general Turkish population. Awareness and behavior of the women were better about mammography when compared to the Pap test. Considering our results, some measures should be put in place to increase people’s awareness, and to modify their behavior toward cancer prevention