ABSTRACT
Xeroderma pigmentosum (XP) is an autosomal recessive disease characterized by solar sensitivity, photophobia, early onset of freckling, and solar-induced cutaneous neoplastic changes. Management of patients with XP is a therapeutic challenge as they usually develop multiple cutaneous malignancies, making surgical therapy difficult, and continue to form skin malignancies at a high rate. We describe a 30-year-old Chinese man with XP who had been previously treated with excision and dermatoplasty. Upon recurrence of multiple superficial, ulcerative, and pigmented lesions, imiquimod 5% cream was recommended for 4 months. His multiple facial lesions demonstrated an excellent response to topical imiquimod 5% cream with minor side effects. This favorable response indicates that topical application of imiquimod 5% cream is an effective means of treating multiple basal cell carcinomas in XP.
Subject(s)
Aminoquinolines/therapeutic use , Antineoplastic Agents/therapeutic use , Carcinoma, Basal Cell/drug therapy , Facial Neoplasms/drug therapy , Neoplasms, Multiple Primary/drug therapy , Neoplasms, Second Primary/drug therapy , Skin Neoplasms/drug therapy , Xeroderma Pigmentosum/complications , Administration, Cutaneous , Adult , Aminoquinolines/administration & dosage , Antineoplastic Agents/administration & dosage , Carcinoma, Basal Cell/complications , Facial Neoplasms/complications , Humans , Imiquimod , Male , Neoplasms, Multiple Primary/complications , Neoplasms, Second Primary/complications , Skin Neoplasms/complicationsABSTRACT
OBJECTIVE: To explore the clinical characteristics, diagnosis and therapy of thyroid carcinoma in children. METHODS: Clinical data of 12 children under the age of 14 years, diagnosed as thyroid carcinoma between August 1998 and August 2008, were reviewed. RESULTS: A hard thyroid mass was observed in 10 out of 12 children with thyroid carcinoma, but only one out of 15 children with benign thyroid tumor (<0.05). The rate of cervical lymph node metastasis in children with thyroid carcinoma was significantly higher than that in children with benign thyroid tumor (<0.05). There was no significant difference in the final diagnostic rate of thyroid carcinoma between ultrasonography and CT scans (75% vs 83%; >0.05). All of 12 cases were pathologically confirmed as differentiated thyroid carcinoma, including papillary carcinoma (7 cases), follicular carcinoma (3 cases) and papillary-follicular carcinoma (2 cases). Nine patients (75%) had cervical lymph node metastasis. All patients received surgical treatment and postoperative thyroxin therapy. No patient was administered with postoperative radioiodine 131I therapy. Unilateral lobectomy plus isthmectomy along with a functional cervical lymph node dissection was a primary operation mode (83%). The follow-up period was 2 months to 10 years. The 5-and 10-year survival rates were 100%. CONCLUSIONS: Childhood thyroid carcinoma is mostly differentiated and characterized by hard thyroid mass and cervical lymph node metastasis. A combination of ultrasonography and CT is helpful to the diagnosis of childhood thyroid carcinoma. The treatment outcome may be satisfactory by optimal therapy in children with thyroid carcinoma.
Subject(s)
Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/surgery , Adolescent , Child , Female , Follow-Up Studies , Humans , Iodine Radioisotopes/therapeutic use , Male , Postoperative Complications/etiology , Tomography, X-Ray ComputedABSTRACT
A number of studies have been conducted to explore the association of XRCC1 polymorphisms with thyroid cancer risk, but the results have been inconsistent. Thus we performed the present meta-analysis to clarify this issue based on all of the evidence available to date. Relevant studies were retrieved by searching PubMed and statistical analysis conducted using Stata software. Nine studies were included in this meta-analysis (1,620 cases and 3,557 controls). There were 6 studies (932 cases and 2,270 controls) of the Arg194Trp polymorphism, 7 studies (1432 cases and 3356 controls) of the Arg280His polymorphism and 9 studies (1,620 cases and 3,557 controls) for the Arg399Gln polymorphism. No association of XRCC1 Arg194Trp, Arg280His and Arg399Gln polymorphism with thyroid cancer risk was observed in the overall analysis. However, subgroup analysis revealed: 1) an elevated risk in aa vs AA analysis (OR=2.03, 95%CI= 1.24-3.31) and recessive genetic model analysis (OR=1.93, 95%CI= 1.20-3.08) in the larger sample size trials for XRCC1 Arg194Trp polymorphism; 2) a decreased thyroid cancer risk on subgroup analysis based on ethnicity in Aa vs AA analysis (OR=0.84, 95%CI= 0.72-0.98) and in a dominant genetic model (OR=0.84, 95%CI= 0.72-0.97) in Caucasian populations for the XRCC1 Arg399Gln polymorphism; 3) a decreased thyroid cancer risk on subgroup analysis based on design type in Aa vs AA analysis (OR=0.72, 95% CI= 0.54-0.97) among the PCC trials for the Arg399Gln polymorphism. Our results suggest that the XRCC1 Arg399Gln polymorphism may be associated with decreased thyroid cancer risk among Caucasians and XRCC1 Arg194Trp may be associated with a tendency for increased thyroid cancer risk in the two larger sample size trials.