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[en] A patient is described who was thought to have the Nevoid Basal Cell Carcinoma Syndrome and who developed multiple squamous carcinomas of the skin. The patient later presented with two mucosal squamous carcinomas of the oropharynx and post-cricoid regions. 5 refs.; 2 tabs
[en] The Tunisian National Health Insurance Fund (TNHIF) has 186 practitioners and advisers (physicians, dentists and pharmacists) in the service of medical supervision. These advisers are distributed on three levels (regional, district and national). In the present paper we have discussed the CNAM support in the different types of oncology (FSD (Fully Supported Disorders), Hospitalization, the scans, the radiation therapy, specific drugs and treatment abroad). We begin by presenting expenditures by year and age group for FSD and hospitalization in the private and the public sectors. We then give the conventional packages for scans, radiotherapy: either for CLAM or CRAM. Daily benefits for the sickness leave and the disability will be presented briefly. Then we will give the administrative process for the approval of the commission for specific medication. The medical advice is based on certain criteria that will be explained in the paper. In certain cases definitive medical advice needs to call for the recommendation of a national commission and oncology or different experts. The spending trend of the TNHIF from 2001 to 2012 will be discussed. TNHIF generally considered Herceptin, Nexavar Erbitaux as the main drugs for targeted therapies. We present for the treatment cost and expenditure trends for the first drug from 2008 to 2012 as well as the estimation for 2013, which increases from one year to year. For the treatment with the second and the third drug we give the evolution of expenditure between 2010 and 2012. Cancer is a serious disease that requires a costly multidisciplinary support for the patients. This support has changed the prognosis survival (see cases of healing). The financial coverage of this support can never be supported by the family (whatever the wealth level) without any TNHIF support. The real gain in survival and expenditure control are closely related to awareness and early detection of the disease. TNHIF usually intervenes in the financing of care abroad as PET SCAN and nonfamily Allograft that we present the number attributed each year. We conclude with statistics on expenditures in cancer diseases: increased spending from one year to year (2010-2011), the number of cancer care abroad (2010-2011-2012) and at the end the number of PET tumour location. (Author)
[en] A P1 (jun/fos) transcription factors (c-jun, jun B, jun D, c-fos, Fos B, Fr a-1, and Fr a-2) are key regulators of epidermal keratinocyte survival and differentiation and important drivers of cancer development. Understanding the role of these factors in epidermis is complicated by the fact that each protein is expressed, at different levels, in multiple cells layers in differentiating epidermis, and because A P1 transcription factors regulate competing processes (i.e., proliferation, apoptosis, and differentiation). Various in vivo genetic approaches have been used to study these proteins including targeted and conditional knockdown, overexpression, and expression of dominant-negative inactivating A P1 transcription factors in epidermis. Taken together, these studies suggest that individual A P1 transcription factors have different functions in the epidermis and in cancer development and that altering A P1 transcription factor function in the basal versus supra basal layers differentially influences the epidermal differentiation response and disease and cancer development.
[en] To investigate the sonographic features including color Doppler pattern of pilomatrixoma in children. We respectively reviewed the ultrasonographic features of 11 patients (M:F=9:2) who had pathologically proven as pilomatrixoma for 5 years. Their age ranged from 1 to 11 years (average: 4.3 years old). Imaging performed under a 7 MHz linear transducer and color Doppler ultrasonography was additionally performed in 9 cases. The analysis of ultrasonographic features was focused on the lesion's location, shape, size, and margin of mass, internal echogenicity and periphery of mass, calcification, and the color Doppler signal. On the color Doppler examination, we assessed the Doppler signals inner and outer portions of mass. The masses were detected in the cheek (n=5), preauricular area (n=3), eyebrow (n=1), zygomatic area (n=1), and submandibular area (n=1), and all were localized within the subcutaneous fat layer. All masses were oval shaped and their sizes were measured as 3.6-15.2 X 7.0-22.9 mm. The margin of masses was well-defined in 10/11 (91%) and ill-defined in 1/11 (9%). Internal echogenicity of all masses were hypoechoic, which was heterogeneous in 8/11 (73%) or homogeneous in 3/11 (27%). Posterior shadowing was seen in 7/11 (64%). Hypoechoic rim (thickness: 0.4-1.9 mm) was visualized in 7/11 (64%). In one Doppler examination, color Doppler flow signals were observed in the inner portion of the masses in 4/9 (44%) and outer portion of the masses in 7/9 (78%). The sonographic features of pilomatrixoma are hypoechoic mass with well-defined margin and calcification within the subcutaneous fat layer. Color Doppler signals can be observed in the inner and/or outer portion of the pilomatrixoma.
[en] Appearance of spreading skin metastases in colorectal cancer and of anal canal is infrequent. The aim of present paper was to show an interesting case of skin metastasis related to an advanced carcinoma of anal canal infiltrating rectum. (Author)
[en] Skin cancer is rare among Africans and albinism is an established risk for skin cancer in this population. Ultraviolet radiation is highest at the equator and African albinos living close to the equator have the highest risk of developing skin cancers. This was a retrospective study that involved histological review of all specimens with skin cancers from African albinos submitted to The Regional Dermatology Training Center in Moshi, Tanzania from 2002 to 2011. A total of 134 biopsies from 86 patients with a male to female ratio of 1:1 were reviewed. Head and neck was the commonest (n = 75, 56.0%) site affected by skin cancers. Squamous cell carcinoma (SCC) was more common than basal cell carcinoma (BCC) with a ratio of 1.2:1. Only one Acral lentiginous melanoma was reported. Majority (55.6%) of SCC were well differentiated while nodular BCC (75%) was the most common type of BCC. Squamous cell carcinoma is more common than basal cell carcinoma in African albinos
[en] Objective: To determine the prevalence of ACD in atopics in comparison to non-atopics in our community. Design: Cross sectional study. Place and Duration of Study: Departments of Dermatology, King Edward Medical College/Mayo Hospital, Lahore, from May 1998 to July 1999. Subjects and Methods: Two hundred and fifty patients, 34 with past or present atopic dermatitis (Group I), 88 with personal or familial atopy (Group II) and 128 non-atopic with contact dermatitis (Group III) were subjected to patch testing with European standard series. The results were interpreted according to International Contact Dermatitis Research Group guidelines. Results: Positive reactions were seen in 50%, 70.4% and 67.8% of patients in the respective groups (p>0.05). Conclusion: Our results suggest that atopics are equally affected with contact dermatitis as compared with non-atopics and recalcitrant cases of atopic dermatitis should be patch tested to find out aggravating factors. (author)
[en] Accuracy of relative dose distributions calculated by TPS was within tolerance levels for all the evaluated test cases; however, TPS monitor unit (MU) computations were not acceptable, so the system was not clinically commissioned for that purpose. an experimental method was validated for estimation of the characteristic β angle and subsequent calculation or required MU. The proposed system has been dosimetrically commissioned and pilot tested clinically on a real patient; a high percentage short term tumor remission has been observed, accompanied with acceptable radiation complications, making the methodology very promising. (Author)
[en] Purpose: Primary cutaneous neuroendocrine (Merkel cell) carcinoma is a rare neoplasm with aggressive behavior but potential for response to radiotherapy and chemotherapy. Optimal treatment regimens are evolving based on reports of case series and a growing understanding of the natural history. Methods and Materials: A retrospective analysis of 34 cases treated at two Australian Institutions over 13 years is presented, focusing on clinical features and response to therapy. Results: The aggressive nature of this neoplasm is confirmed by the local recurrence rate of 22% following surgical excision, the development of regional node metastases in 76%, and of distant metastases in 70%. Overall median survival was 24 months with 65% of patients succumbing to metastatic disease. An association with B cell malignancies and immunosuppressive therapy is noted, with these patients having a poorer outcome, and one spontaneous remission was observed. Radiation therapy produced responses in 21 of 30 measurable sites (11 complete, 10 partial), and in 11 sites irradiated prophylactically there was only one infield relapse (9%). Responses to chemotherapy were observed in 8 of 20 applications (40%), particularly carboplatin and etoposide given in the setting of regional node disease. Conclusion: In this poor prognosis tumor, further investigation of adjuvant radiotherapy and chemotherapy is warranted, as responsiveness of recurrent disease is confirmed. Immunological factors appear important in the natural history, and their manipulation may offer additional therapeutic options
[en] Epithelioid angiomyolipoma (EAML) is an uncommon, variant type of angiomyolipoma with a possibility of metastatic transformation and distant spread. Angiomyolipomas, including epithelioid variant type, are mostly renal in origin. EAML originating from extrarenal location is very rare and imaging findings are not well described. Herein, we reported a very rare case of EAML arising from the perirenal space that mimicked a malignant retroperitoneal tumor, in a 39-year-old female