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   Table of Contents - Current issue
April-June 2020
Volume 7 | Issue 2
Page Nos. 49-98

Online since Tuesday, June 2, 2020

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Dissecting the functional pleiotropism of lysine demethylase 5B in physiology and pathology Highly accessed article p. 49
Oluwaseun Adebayo Bamodu, Tsu-Yi Chao
Background: The last two decades has been characterized by accruing evidence of the translational relevance of chromatin modification in normal genomic function, regulation, and pathology, especially with piqued interest in the intrinsic regulatory dynamism of histone methylation, and the increasing documentation of new members of the histone demethylase family. Recent studies provide functional and mechanistic insight into the peculiar biological role of these histone demethylases and their putative implication in pathological processes. Objective: This review aims to provide a summary of the latest findings related to pleiotropic roles of the Jumonji/AT-rich interactive domain (JARID) domain-containing lysine demethylase 5B (KDM5B, also known as JARID1B or PLU1) in physiology and pathology, with a focus on its therapeutic potentials. Results: KDM5B/JARID1B/PLU1 is restrictively expressed, evolutionarily conserved across mammalian species, and belonging to the α-ketoglutarate-dependent hydroxylase superfamily. KDM5B is actively involved in various physiological processes, including regulation of transcription elongation and alternative splicing in embryonic stem cells, epigenetic modulation of gene expression, neurogenesis, mammary gland development, and osteogenesis. Conversely, KDM5B is one of the earliest identified histone lysine demethylases associated with human disease, with several studies indicating that KDM5B plays a vital role in the initiation and progression of various malignancies, including lung, hypopharynx, brain, and breast cancers. Conclusion: This study provides concise insight into the functional pleiotropism of KDM5B in physiology and pathology, as well as highlights it role as an actionable therapeutic target.
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Knowledges, attitudes, and practices on cervical cancer screening by women in Brazzaville-Congo p. 60
Pierre Marie Tebeu, Jesse Saint Saba Antaon, Sylvain Honoré Woromogo, Wilfried L Tatsipie, Chrismichel Kibimi, Rostand Njiki
Background: Cervical cancer is a serious disease, responsible for more than 311,000 deaths worldwide each year. The objective of the study was to assess the knowledge, attitudes, and practices (KAPs) regarding cervical cancer screening of women aged 25–65. Materials and Methods: This was an analytical KAP study conducted from May 2, 2018, to August 10, 2018, including women aged 25–65 years, attending the gyneco-obstetrics departments of six hospitals in Brazzaville. The variables of interest were sociodemographic and reproductive characteristics, KAPs. Frequencies, central tendency parameters, and odds ratios were calculated using Epi Info software. We used Pearson, Fisher, and Wald statistical tests, with a significance level of 0.05. Results: We interviewed 169 women aged 25–65 years (average 35 [±9.05] years). The majority had an unsatisfactory level of knowledge (70.41%), favorable attitudes (56.21%), and bad practices (43.20%). Factors associated with better knowledge were at least secondary school education (adjusted odds ratio [ORa]: 1.76 [1.02–3.34]) and being employed (ORa: 4.24 [2.60–6.93]). Women with the best knowledge had the best attitudes (ORa: 3.86 [2.38–6.26]) and best practices (ORa: 5.28 [3.08–9.05]). Those with better attitudes had better practices (ORa: 2.94 [1.87–4.61]). Conclusion: Women in Brazzaville lack knowledge about cervical cancer. Better knowledge and attitudes were associated with best practices, hence the need to implement awareness – raising strategies to give greater impetus to the participation of Congolese women in cervical cancer screening.
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Histological profile of kidney malignancies at a tertiary hospital in the Ashanti Region Of Ghana; A 9-year review p. 67
Paul Poku Sampene Ossei, Benedict Mawuli Agagli, William Gilbert Ayibor, Nicholas Niako, Emmanuel Asante
Background: Kidney cancer is the 14th most prevalent cancer worldwide, however, it is relatively less common in Ghana compared to other countries in northern and southern Africa. This study presents the profile and prevalence of kidney cancer cases in Ghana. Methods: The study analyzed the histopathological data of 321 cases of kidney cancer obtained from pathology records at Komfo Anokye Teaching Hospital, Ghana. Results: Most of the kidney malignancies were Wilm's tumor (WT) (nephroblastoma), accounting for 44% (n = 141) of all cases, followed by renal cell cancer (RCC) (40%, 127), kidney lymphoma (11%, 37), urothelial caner (4%, 13), and sarcoma (1%, 3). Children were most affected by the disease, especially WT. Age distribution of the disease was right skewed, and trend analysis showed a slight decline since 2014. Conclusion: WT is the most common type of kidney cancer in Ghana followed by RCC. The implementation of Ghana's “National Strategy for Cancer Control 2012–2016” has led to a large decrease in the occurrence of the disease in the country.
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A patient with hepatic angiosarcoma and Kasabach–Merritt syndrome effectively controlled by weekly paclitaxel therapy p. 74
Sheng- Yu Hung, Tom Wei-Wu Chen
Angiosarcoma accounts for <2% of all soft-tissue sarcomas, and weekly paclitaxel treatment offers clinical benefits and good tolerance. Kasabach–Merritt syndrome (KMS) is a consumptive coagulopathy status associated with vascular tumors. We report a case of hepatic angiosarcoma complicated with KMS who achieved good control in about 2 months under weekly paclitaxel. We also discuss the presentation, diagnosis, and treatment of angiosarcoma with KMS and bone marrow involvement.
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A case of small-cell lung cancer harboring an epidermal growth factor receptor mutation that responded to epidermal growth factor receptor tyrosine kinase inhibitor treatment p. 78
Ching- Fu Chang, Chih- We Wang, Cheng- Lung Hsu
Epidermal growth factor receptor (EGFR) mutations are extremely rare in small-cell lung cancer (SCLC), and the efficacy of EGFR tyrosine kinase inhibitors (TKIs) in SCLC is unclear. Herein, we present a case with SCLC harboring an EGFR mutation who also responded to a second-generation EGFR TKI (afatinib).
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A rare case of contralateral ciliated muconodular papillary tumor after limited surgery p. 82
Chen- Hao Hsiao, Jen- Hsien Liao, Wei- Kang Kwang, Wei- Teing Chen
Ciliated muconodular papillary tumor (CMPT) was a rare tumor with low-grade malignancy. The histopathogenesis of CMPT remains unclear. Three typical components are ciliated columnar cells, goblet cells, and basal cells. Limited resection is sufficient for CMPT. No recurrences or metastases have been reported. Herein, we reported a 73-year-old man who presented with right lower lobe partial sold nodule. He received partial resection for the right lower lobe tumor. CMPT was confirmed. However, contralateral left lower lobe ground-glass opacity (GGO) was found 3 months later. He received partial resection for the left lower lobe GGO. CMPT was diagnosed again. Double primary CMPTs were recognized because morphologic patterns were different. At his 2-year follow-up, there was no local recurrence or metastasis.
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Angiosarcoma of the scalp: What is the optimum management? p. 85
Kaalindi Singh, Thomas Samuel Ram, Jebakarunya Rami Reddy, Arvind Murthy
Scalp angiosarcoma is a rare malignancy with a poor outcome. In the absence of randomized trials, the approach to management depends on retrospective series and case reports. Here, we report a 56-year-old male diagnosed initially with squamous cell carcinoma of the scalp at an outside center. When he underwent re-excision for recurrence in our center, histopathology showed a high-grade angiosarcoma. He was offered postoperative radiotherapy for the primary site. During the treatment, he developed preauricular nodal recurrence, which was also treated with radiotherapy. After radiotherapy, he had persistent preauricular nodes, for which single-agent chemotherapy was given, and the nodes were regressed. However, the recurrence of preauricular nodes was noted at the next follow-up visit, and he was re-evaluated with a positron emission tomography-computed tomography scan, which showed an extensive lung and nodal metastases. He was started on metronomic chemotherapy and his disease was stable at the time of the last follow-up. This case raises several questions, including whether electively addressing the regional nodes in the scalp angiosarcoma could improve the outcomes, whether higher doses of radiotherapy are beneficial or only add to the toxicity of treatment, the role that chemotherapy plays and the most appropriate regimen. Although some relevant studies have been discussed in brief, more evidence is needed to answer these questions.
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A neurofibromatosis type I patient presenting with four different cancer types including malignant peripheral nerve sheath tumor, gastrointestinal stromal tumor, pancreatic neuroendocrine tumor, and renal cell carcinoma within 1 year p. 90
Po- Ju Chiu, Yen- Lin Huang, Tom Wei-Wu Chen
Neurofibromatosis type 1 (NF1) is a germline autosomal dominant disorder caused by the loss-of-function tumor suppressor gene NF1, which encodes neurofibromin protein. When multiple tumors arise within a short time in patients with the germline NF1 mutation, it is important to determine whether the tumors are metastatic or different primary tumors. We, herein, report a 35-year-old female with multiple tumors that were confirmed to be a malignant peripheral nerve sheath tumor, gastrointestinal stromal tumor, renal cell carcinoma, and pancreatic neuroendocrine tumor, and all were treated accordingly. This case further supports that tissue confirmation is important in patients with the NF1 germline mutation.
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Puzzling Papules on the neck: Cutaneous metastasis from the breast p. 95
Ajinkya Sawant, Sumit Kar, Safa Patrick, Nitin Gangane
Cutaneous metastasis from a primary internal malignancy is rare. Breast cancer is the most common primary internal malignancy presenting with cutaneous metastases, and it presents in various morphological and histological forms. Medical practitioners should be aware of the possibility of the unusual presentation of an internal malignancy mimicking a dermatological condition. Herein, we report a case of 50-year-old women with ductal carcinoma of the breast with a cutaneous manifestation of secondary metastatic deposits in the skin.
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Corrigendum: A 54-year-old man with primary mediastinum choriocarcinoma p. 98

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