Early Detection Of Recurrence Research Articles

Liver transplantation for combined hepatocellular carcinoma and cholangiocarcinoma: A multicenter study.

Patients with combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) are not traditionally considered eligible for liver transplantation (LT) due to poor outcomes. To compare outcomes between living donor LT (LDLT) patients with hepatocellular carcinoma (HCC) and LT patients with cHCC-CC and to identify risk factors for tumor recurrence and death after LT in cHCC-CC patients. Data for pathologically diagnosed cHCC-CC patients (n = 111) who underwent LT from 2000 to 2018 were collected for a nine-center retrospective review. Patients (n = 141) who received LDLT for HCC at Samsung Medical Center from January 2013 to March 2017 were selected as the control group. Seventy patients in two groups, respectively, were selected by 1:1 matching. Cumulative disease-free survival (DFS) and overall survival (OS) in the cHCC-CC group were significantly worse than in the HCC group both before and after matching. Extrahepatic recurrence incidence in the cHCC-CC group was higher than that in the HCC group (75.5% vs 33.3%, P < 0.001). Multivariate analysis demonstrated that the cHCC-CC group had significantly higher rates of tumor recurrence and death compared to the HCC group. In cHCC-CC subgroup analysis, frequency of locoregional therapies > 3, tumor size > 3 cm, and lymph node metastasis were predisposing factors for tumor recurrence in multivariate analysis. Only a maximum tumor size > 3 cm was a predisposing factor for death. The poor prognosis of patients diagnosed with cHCC-CC after LT can be predicted based on the explanted liver. Frequent regular surveillance for cHCC-CC patients should be required for early detection of tumor recurrence.

Surveillance After a Previous Cutaneous Melanoma Diagnosis: A Scoping Review of Melanoma Follow-Up Guidelines.

Cutaneous melanoma accounts for more than 70% of all skin cancer deaths. Follow-up surveillance is an integral part of melanoma patient care, to facilitate early detection of recurrences and subsequent primary melanomas. The purpose of this scoping review is to provide an overview of recently published melanoma surveillance guidelines from regional and national melanoma working groups. A systematic search for relevant studies in MEDLINE and Embase was conducted in September 2022 and was limited to publications from 2010 or later. A total of 1047 articles were retrieved, and after abstract and full text review, 26 articles from 19 different organizations met inclusion criteria. Life-long annual skin surveillance with a physician was recommended by 53% (9/17) of guidelines. Routine laboratory investigations were recommended by 7/19 guidelines. Regional lymph node ultrasound was recommended by 9/16 guidelines, most often in stage IB or higher, and was optional in 7/16 for patients who met specific criteria. Surveillance with PET-CT or CT and MRI was recommended by 15 and 11 guidelines, respectively, most commonly in stage IIC or higher, with a variable frequency and total duration. Five out of 9 guidelines indicated a preference for skin surveillance to be completed with a dermatologist. Guidelines were highly variable for many aspects of melanoma surveillance, which may be partly attributed to regional differences in healthcare workforce distribution and availability of imaging technologies. Further high-level studies are recommended to provide more evidence on the most effective clinical and imaging follow-up surveillance protocols.

Molecular Imaging of Glial Tumors: Established and Emerging Tracers

AbstractVarious positron emission tomography (PET) tracers have been developed and extensively studied in the field of neuro-oncology imaging. In the management of brain tumors, accurate delineation of tumor extent, assessment of treatment response, and detection of early recurrence are the most important factors. At present, conventional anatomical imaging paired with amino acid tracer PET imaging is the recommended imaging modality for glial tumor evaluation. Newer PET tracers targeting various structures in the tumor microenvironment have been extensively studied. This review summarizes the established and emerging PET tracers having potential impact on neuro-oncology practice.

Xpert Bladder Cancer Monitor for the Early Detection of Non-Muscle Invasive Bladder Cancer Recurrences: Could Cystoscopy Be Substituted?

XBM was prospectively assessed in spontaneous urine collected just before flexible cystoscopy and washing cytology carried out within the first 2 years follow-up of 337 patients with NMIBC. Recurrences were pathologically confirmed in 49 patients (14.5%), 22 of them being high-risk (6.5%). The XBM sensitivity for detecting any type of recurrence was 69.4% and 63.6% in the cases of high-risk NMIBC. Negative predictive value (NPV) for XBM was 93% for all recurrences and 96.2% for high-risk recurrences. XBM could have avoided 213 invasive controls but missed the detection of 15 recurrences (30.6%)-8 of them of high-risk (36.4%). XBM false positive elevations were detected in 90 patients (26.7%), whereas 10 patients with the invasive method had a false positive result (3%), p <0.001. However, early detection of recurrences during the first year's follow-up after an XBM false positive result was observed in 18 patients (20%). On the other hand, 19 recurrences were detected during this period among the rest of the patients (7.7%)-p = 0.003, and odds ratio (OR) 3.0 (95% CI 1.5-6.0). Regarding one-year follow-up recurrences, 10% were high-risk recurrences in the XBM false positive group and 3.2% in the rest of the patients-p = 0.021, and OR 3.3 (95% CI 1.2-8.9). Additionally, 11.3% of the patients without false positive results developed a recurrence, p = 0.897, for any recurrence, being 10% and 5.2%, respectively, and high-risk and low-risk recurrences, p = 0.506. After searching for the best XBM cutoff for detecting the 38 high-risk initial recurrences and the early high-risk recurrences after a one-year follow-up, a linear discriminant analysis (LDA) of 0.13 could have avoided 11.3% of cystoscopies and bladder wash cytologies, as this cutoff missed only 1 high-risk recurrence (2.6%). More extensive and well-designed studies will confirm if XBM can improve the surveillance of NMIBC.

Significance of Early Postoperative Magnetic Resonance Imaging following Intracranial Meningioma Resection.

The significance of early postoperative magnetic resonance imaging (MRI) for meningioma resection has not yet been evaluated. We retrospectively reviewed patients with intracranial meningiomas resected at our institute between 2011 and 2021. Early postoperative MRI with contrast enhancement was routinely performed within 48 h after surgery while first follow-up MRI was performed approximately after 6 months. MRI findings were reviewed, and the risk factors for postoperative infarction and early recurrence were analyzed. Among the 245 resections performed, early postoperative MRI was performed in 200 cases. Postoperative radiological and symptomatic infarctions occurred in 54 (27%) and 17 patients (9%), respectively. Diameter > 5 cm (p = 0.015) and skull base location (p = 0.010) were independent risk factors for radiological infarctions. Follow-up postoperative MRI performed in 180 patients (90%) detected early recurrence in 24 patients (13%). Non-gross total resection was an independent risk factor for early recurrence (p < 0.0001). Additionally, early recurrence after gross total resection occurred significantly more frequently in meningiomas with dural sinus involvement than in those without (8.3% vs. 0%, p = 0.018). Thus, early postoperative MRI may enable the timely assessment of postoperative neurological deficits, especially after large skull base meningioma resections along with accurate detection of early recurrence, which is critical for meningiomas with dural sinus involvement.

The Role Of 18F-FDG PET/CT In Evaluation Of Primary CNS Lymphoma: The Path Less Travelled.

Primary central nervous system lymphoma (PCNSL) is a rare but highly aggressive lymphoma with increasing incidence in immunocompromised patients. MRI is the modality of choice in evaluating brain lesions. However, MRI is often challenging in the detection of early recurrence, assessing residual disease and response evaluation in PCNSL. 18F-FDG PET/CT has superior diagnostic performance compared with body CT in the evaluation of lymphoma. 18F-FDG PET-CT is helpful in evaluating evaluation of disease extent and differentiating primary CNS lymphoma from systemic lymphoma. Besides diagnostic and prognostic value in primary CNS lymphoma, it might also be helpful in response assessment. The role of FDG-PET in PCNSL is not fully defined. In this article we have reviewed the potential role of 18F-FDG PET/CT in initial diagnosis, baseline staging, restaging, evaluation of treatment response, prognostication, and survival analysis of PCNSL.

Practical recommendations for using ctDNA in clinical decision making.

The continuous improvement in cancer care over the past decade has led to a gradual decrease in cancer-related deaths. This is largely attributed to improved treatment and disease management strategies. Early detection of recurrence using blood-based biomarkers such as circulating tumour DNA (ctDNA) is being increasingly used in clinical practice. Emerging real-world data shows the utility of ctDNA in detecting molecular residual disease and in treatment-response monitoring, helping clinicians to optimize treatment and surveillance strategies. Many studies have indicated ctDNA to be a sensitive and specific biomarker for recurrence. However, most of these studies are largely observational or anecdotal in nature, and peer-reviewed data regarding the use of ctDNA are mainly indication-specific. Here we provide general recommendations on the clinical utility of ctDNA and how to interpret ctDNA analysis in different treatment settings, especially in patients with solid tumours. Specifically, we provide an understanding around the implications, strengths and limitations of this novel biomarker and how to best apply the results in clinical practice.

The timing and methods for detection of recurrence in patients with head and neck cancer

Background Early detection of head and neck cancer recurrence after curative treatment is crucial for effective salvage treatment. Objective We aimed to examine the timing and method that allowed early detection of recurrence in each primary and recurrence site. Materials and methods We enrolled 440 patients with head and neck squamous cell carcinoma (HNSCC) in the oral cavity, oropharynx, hypopharynx, or larynx who underwent curative treatment focusing on surgery at our hospital between 2009 and 2018. We examined the timing and diagnostic method (clinical examination, patient symptoms, or imaging examination) for HNSCC recurrence according to the primary and recurrence sites. Results Recurrence was observed in 133 patients. In all primary sites, regional recurrence occurred significantly earlier than local and distant recurrences. Local recurrence occurred later in the larynx than in other primary sites. Furthermore, the clinical examination had a higher ratio of detection of local recurrence in the larynx than in the other primary site. Regardless of the primary site, more than half of the regional recurrences and most of the distant recurrences were detected by imaging examination. Conclusions and significance Imaging examination is preferable for achieving early detection of regional and distant recurrences.

BI18 The role of an acute on-call dermatology service in a haemato-oncology unit using pioneering treatments: a retrospective analysis of 134 dermatology consultations in a tertiary hospital

Abstract Our dermatology department receives the largest number of internal on-call referrals from the haematology–oncology department. Patients with haematological malignancies are particularly vulnerable to an array of dermatological conditions due to immunosuppression and multiagent exposure, which can impact cancer treatment and result in significant morbidity and even mortality. Our primary objective was to quantify and analyse the dermatological conditions encountered. Our secondary objective was to identify potential associations of dermatological conditions with haematological malignancy subtype and anticancer therapies. We conducted a retrospective single-centre review of acute haematology–oncology referrals to an on-call dermatology service made between August 2020 and November 2022. Consultations were retrospectively identified from the dermatology on-call referral log. In total, 134 patients were identified. Underlying haematological malignancies were categorized into lymphoid neoplasms (45%), myeloid neoplasms (29%), plasma cell dyscrasias (13%), Hodgkin lymphoma (6%) and other (7%), with acute myeloid leukaemia (AML; 20%) being the most frequently seen distinct haematological malignancy. Cutaneous adverse drug eruptions (23%), infections (13%), folliculitis/acneiform eruptions (10%) and eczematous dermatoses (7%) accounted for the most common diagnoses, followed by benign skin lesions (6%), cutaneous lymphoma (6%), leukaemia cutis (5%) and cutaneous vasculitis (4%). Notably, cutaneous drug reactions frequently occurred in patients with myeloid neoplasms (32%) and, out of all malignancies, most frequently in multiple myeloma (26%). Folliculitis and acneiform eruptions occurred predominantly in patients with myeloid lineage malignancy (i.e. AML and myelodysplastic syndrome; 73%), although it is unclear whether they were triggered by the underlying malignancy or treatment received. Fifteen patients (11.2%) undergoing novel chimeric antigen receptor (CAR) T-cell therapy were referred to our on-call dermatology service. In conclusion, dermatology plays an integral consultative service to patients from haematology–oncology. Skin biopsy is diagnostically useful and has been crucial in the early detection of lymphoma and leukaemia recurrence. However, with the recent development of new CAR T-cell therapies and other novel agents, new adverse dermatological complications are surfacing, and this is likely to increase the demand for dermatology input.

VCAM-1 complements CA-125 in detecting recurrent ovarian cancer

BackgroundClose to three-quarters of ovarian cancer cases are frequently diagnosed at an advanced stage, with more than 70% of them failing to respond to primary therapy and relapsing within 5 years. There is an urgent need to identify strategies for early detection of ovarian cancer recurrence, which may lead to earlier intervention and better outcomes.MethodsA customized magnetic bead-based 8-plex immunoassay was evaluated using a Bio-Plex 200 Suspension Array System. Target protein levels were analyzed in sera from 58 patients diagnosed with advanced ovarian cancer (including 34 primary and 24 recurrent tumors) and 46 healthy controls. The clinical performance of these biomarkers was evaluated individually and in combination for their ability to detect recurrent ovarian cancer.ResultsAn 8-plex immunoassay was evaluated with high analytical performance suitable for biomarker validation studies. Logistic regression modeling selected a two-marker panel of CA-125 and VCAM-1 that improved the performance of CA-125 alone in detecting recurrent ovarian cancer (AUC: 0.813 versus 0.700). At a fixed specificity of 83%, the two-marker panel significantly improved sensitivity in separating primary from recurrent tumors (70.8% versus 37.5%, P = 0.004), demonstrating that VCAM-1 was significantly complementary to CA-125 in detecting recurrent ovarian cancer.ConclusionsA two-marker panel of CA-125 and VCAM-1 showed strong diagnostic performance and improvement over the use of CA-125 alone in detecting recurrent ovarian cancer. The experimental results warrant further clinical validation to determine their role in the early detection of recurrent ovarian cancer.

DIFFICULTY OF DIAGNOSING METASTATIC BREAST CANCER IN A PATIENT AFTER MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT: A CLINICAL CASE

HighlightsThe article describes a clinical case of a patient with metastatic breast cancer detected after aortic valve replacement. The case was initially treated as sternal osteomyelitis due to ministernotomy performed during aortic valve surgery. However, the diagnosis of metastatic breast cancer with sternal and spinal (third thoracic vertebra) metastatses, and ribs lesion was established upon further study. Adjuvant endocrine therapy was prescribed to the patient due to her age and previous surgery. AbstractBreast cancer is an urgent problem in oncology as it remains the most frequent type of cancer in the Russian Federation and world wide. Long-term treatment success and survival of patients depend on selected treatment modality, and long-term postopertive monitoring of patients as the means of the early detection of metastatic recurrence. Furthermore, concominant somatic ilness could change or mask the symptoms of local recurrence or metastasis, resulting in difficulties with establishing the proper diagnosis. We report a clinical case of metastatic breast cancer in a patient with severe aortic stenosis who underwent aortic valve replacement. We have not found analogious cases in domestic and foreign literature.

An approach to the management of recurrent metastatic squamous cell carcinoma of the anus: A case report

Introduction: Anal squamous cell carcinoma (ASCC) is an uncommon gastrointestinal cancer that is increasingly curable when diagnosed in early stages. Distant metastases are relatively uncommon. New technologies have been introduced for the early detection of disease recurrence across all solid tumors, but their role in ASCC has not been well described. We present a case of isolated metachronous metastasis to the lung from primary ASCC, without primary recurrence and the application of circulating tumor DNA (ctDNA) technology in management. Case Report: The patient is a 63-year-old female who presented with altered bowel habits, rectal bleeding and was found to have a 3×2 cm mass fixed to the anal sphincter on colonoscopy. Biopsy showed moderately differentiated invasive squamous cell carcinoma. Imaging revealed inguinal lymphadenopathy but was negative for distant metastases. She underwent definitive chemoradiotherapy without complications. Post-treatment surveillance scans were negative for residual disease or distant metastasis. Two years later, positron emission tomography (PET)/computed tomography (CT) scans revealed a 0.5 cm sub-pleural nodule which when repeated three months later grew to 0.7 cm. The nodule was then surgically resected. Histology was positive for metastatic squamous cell carcinoma, similar to the primary tumor. Given the dearth of data related to treatment in the setting of resected isolated metastatic disease we pursued ctDNA testing which was negative. Given this finding along with the clinical presentation, time to metastasis (two years) and absence of other evidence of recurrence we opted to monitor expectantly rather than administer systemic chemotherapy. Conclusion: Anal squamous cell carcinoma with metachronous distant metastasis is an unusual phenomenon. Treatment with chemotherapy in completely resected metastatic disease is controversial. Use of ctDNA technology may have a role in aiding in this complex decision making.

Melanotic Neuroectodermal Tumor of Infancy: A Case Report with Review of Literature

AbstractMelanotic neuroectodermal tumors of infancy are rare pigmented neuroectodermal locally aggressive tumors that usually occur within 1 year of life. Head and neck areas are frequently involved with maxilla being the most common site. Expansile growth and high recurrence rate are characteristics of this cancer. Though rare, radiologists and clinicians must be aware and should consider this entity when diagnosing pediatric head and neck masses. Computed tomography can be used for diagnosing and looking at the extent of the disease and predicting the operative outcome. Surgery with wide resection margin is the mainstay of treatment for these masses. Surgery followed by adjuvant chemotherapy and radiation is reserved for aggressive malignant lesions. Since it has a high recurrence rate, follow-up is done with imaging and clinical examination. Early detection and treatment of recurrence have a favorable outcome for the patients.

Circulating tumor DNA (ctDNA) and disease recurrence in early stage pancreatic cancer.

e16313 Background: Surgical resection with neoadjuvant and/or adjuvant chemotherapy remains to be the cornerstone in treatment for early-stage pancreatic adenocarcinoma. Disease recurrence after curative intent treatment remains to be very common, and early detection of disease recurrence remains challenging. Recent studies explored the role of ctDNA in guiding adjuvant treatment in colon cancer, but its role in pancreatic cancer remains unknown. Methods: Through comprehensive chart review, we identified patients who: 1. Diagnosed with early-stage pancreatic adenocarcinoma; 2. Underwent curative intent surgery at our institution from 2019 to 2021; 3. Have postoperative tissue informed ctDNA results with commercially available assay (Signatera, by Natera Inc). Results: A total of 14 patients, including 7 males and 7 females, were included in the study. Depending on location of tumor, types of surgery included Whipple procedure (N = 13) and distal pancreatectomy (N = 1). The median age at time of surgery was 62 years (Range: 41-83 years). Two patients received neoadjuvant chemotherapy, and 13 patients received adjuvant chemotherapy. Two patients also received adjuvant radiation. A total of 41 ctDNA readings were obtained. The median time from surgery to first ctDNA assay was 2.4 months. First post-op ctDNA was positive in 6 patients, all of whom received adjuvant chemotherapy but still experienced clinical recurrence after a median of 3.7 months. The median overall survival of those ctDNA+ patients was 11.4 months. In the remaining 8 patients, the median progression free survival was 14 months, with clinical recurrence being observed in 4 patients. Median overall survival was not reached at median follow up of 30.5 months (one patient died at 6 months without disease recurrence, and another died at 14 months with progressive disease). In the 4 patients who had clinical recurrence despite initially negative ctDNA, ctDNA turned positive 1 month before clinical recurrence in 1 patient. However, in the other 3 patients, recurrence occurred 3.1, 1.9 and 3.5 months after the most recent negative ctDNA result. Conclusions: Our study demonstrated that positive ctDNA reliably predicts clinical recurrence in early-stage pancreatic cancer after surgery, with a positive predictive value of 100%. Negative result appears to be less reliable. This may be explained by different shedding pattern and test sensitivity. Larger scale study is underway to further evaluate its role in determining prognosis and guiding adjuvant treatment.

Detection of bladder cancer relapse after TURBT through urinary tumor DNA analysis: A prospective real-world evidence study.

e16605 Background: Bladder cancer is a common malignancy and detection of tumor recurrence is important to improve patient outcomes. Transurethral resection of bladder tumor (TURBT) is the standard treatment for early-stage bladder cancer, but the molecular detection of disease relapse remains a challenge. Reliable and non-invasive methods for monitoring the molecular changes in urine are crucial for timely intervention and disease management. Methods: In this study, 108 patients with early-stage bladder cancer who were selected for detection of disease relapse after the 1st TURBT (median timing 4.8 months after TURBT) were prospectively enrolled. The molecular recurrence in these patients was detected from the urinary tumor DNA (utDNA) using a targeted next-generation sequencing (NGS) assay (PredicineCARE). This assay identifies somatic alterations in utDNA, including single nucleotide variations (SNVs), gene fusions and copy number variations (CNVs), and based on these variations, the tumor fraction was called to identify molecular relapse in the patients. Results: 77 out of 108 (71.3%) patients were found to be tumor positive in utDNA with a tumor fraction ≥ 0.5%. The assay identified 525 SNVs and 32 CNVs in the tumor positive patients. The most frequently mutated genes in the urine samples were TP53 (38%), TERT (32%), KMT2D (28%), ARID1A (19%), FGFR3 (19%), PIK3CA (14%) and ERBB2 (12%). Conclusions: This study demonstrates the feasibility of using urine ctDNA assay to detect molecular recurrence in early-stage bladder cancer patients treated by TURBT. This information can be used to improve patient outcomes by enabling early detection of tumor recurrence and guiding treatment decisions. The findings of this study highlight the promising potential of urine-based NGS assays for cancer detection and disease surveillance.

Optimal Delivery of Follow-Up Care Following Treatment for Adults Treated for Ewing Sarcoma.

Ewing sarcoma (ES) is a rare, highly malignant sarcoma. It usually presents in the second decade of life; however, patients can be diagnosed as early as newborns and as late as in their seventies. ES is most frequently found in the long bones of the extremities and the pelvis. In older patients, ES can also arise in the soft tissues. Currently, there is no standard schedule for surveillance of adult patients with ES after their initial treatment for localised disease, not only for the early detection of recurrence but also for long-term side effects. Follow-up is based on group recommendations using extrapolated data obtained primarily from studies with paediatric patients. The main objective of this review is to summarise the data available on treatment-associated complications in long-term survivors. Furthermore, we provide a set of recommendations for optimising the follow-up of adults ES survivors, as well as for managing the sequelae that result from intensive multimodal treatment.

Identification of Immunoglobulin Gene Rearrangement Biomarkers in Multiple Myeloma through cfDNA-Based Liquid Biopsy Using tchDNA-Seq.

Multiple myeloma (MM) is a hematological malignancy characterized by the clonal proliferation of pathogenic CD138+ plasma cells (PPCs) in bone marrow (BM). Recent years have seen a significant increase in the treatment options for MM; however, most patients who achieve complete the response ultimately relapse. The earlier detection of tumor-related clonal DNA would thus be very beneficial for patients with MM and would enable timely therapeutic interventions to improve outcomes. Liquid biopsy of "cell-free DNA" (cfDNA) as a minimally invasive approach might be more effective than BM aspiration not only for the diagnosis but also for the detection of early recurrence. Most studies thus far have addressed the comparative quantification of patient-specific biomarkers in cfDNA with PPCs and BM samples, which have shown good correlations. However, there are limitations to this approach, such as the difficulty in obtaining enough circulating free tumor DNA to achieve sufficient sensitivity for the assessment of minimal residual disease. Herein, we summarize current data on methodologies to characterize MM, and we present evidence that targeted capture hybridization DNA sequencing (tchDNA-Seq) can provide robust biomarkers in cfDNA, including immunoglobulin (IG) rearrangements. We also show that detection can be improved by prior purification of the cfDNA. Overall, liquid biopsies of cfDNA to monitor IG rearrangements have the potential to provide important diagnostic, prognostic, and predictive information in patients with MM.

Resurfacing the defect from wide excision of a malignant peripheral nerve sheath tumor based on a thoracodorsal artery perforator free flap: a case report

Malignant peripheral nerve sheath tumors (MPNSTs) are rare, aggressive soft tissue sarcomas with a high rate of recurrence and metastasis. Limb salvage surgery with free flap reconstruction is a viable option for selected patients with MPNSTs, but careful consideration should be given to the risk of recurrence. This case report describes a 26-year-old male patient with a recurrent, aggressive, high-grade MPNST who underwent limb salvage surgery with thoracodorsal artery perforator free flap reconstruction. Despite the surgical intervention, local recurrence of the MPNST was detected, and below-knee amputation was ultimately recommended. This case highlights the importance of early, definitive treatment decision-making in cases of aggressive, high-grade MPNSTs. Close postoperative monitoring and early detection of recurrence are crucial for achieving optimal outcomes in patients with MPNSTs undergoing limb salvage surgery with free flap reconstruction.

A Case of Myoepithelioma of Nasal Cavity and Short Review of Literature.

Introduction: Myoepithelioma is a rare neoplasm of the salivary glands and accounts for less than 1% of salivary gland neoplasms. Only 7 cases of myoepithelioma in the nasal cavity have been reported till date in literature. Case Report: A 61 year old male presented to us with epistaxis. There was a pinkish fleshy mass occupying the right nasal cavity. Biopsy showed evidence of an epithelial tumor of intermediate aggressiveness. We did an endoscopic complete excision of nasal cavity mass. Histopathological examination of the resected tumor was consistent with myoepithelioma. Due to its rarity, the nature of the tumor is not known and regular follow-ups are needed for early detection of recurrence and malignancy. There has been no evidence of tumor recurrence in the 18 months following surgery.

SEBACEOUS CARCINOMA ABOUT A CASE

Sebaceous carcinoma is a rare and aggressive skin cancer that originates in the cells of the sebaceous glands. It mainly affects fair-skinned and chronically sun-exposed people, and is commonly located on areas such as the face, scalp, and neck. Diagnosis is based on clinical evaluation and biopsy. The treatment of choice is Mohs surgery and, in some cases, adjuvant radiotherapy. The prognosis is generally good, but the disease may be recurrent and, in advanced cases, there may be metastases. Long-term follow-up is important for early detection of recurrences and metastases. In this clinical case, the diagnosis and treatment of a patient with sebaceous carcinoma is presented. The importance of early detection, accurate diagnosis and a comprehensive approach to care to achieve positive results in the management of this disease will be highlighted.