Mediastinal myxopapillary ependymoma primary or late metastases of paracoccygeal ependymoma: a case report.

A 25-year-old woman presented in 2002 with progressive shortness of breath and weight loss. A computed tomographic scan of the chest showed a huge anterior mediastinal mass, and pathological examination of a mediastinoscopic needle biopsy revealed typical myxopapillary ependymoma, an extremely unusual diagnosis at this site. Further workup and questioning of the patient revealed that she had opted not to disclose a history of surgery for right gluteal fold mass in 1993, which was primarily treated with surgery followed by radiotherapy for relapse. Review of the histology of the excised mass showed a myxopapillary ependymoma, similar to current histology. Clinical examination of the local gluteal and paracoccygeal site, computed tomographic imaging, and magnetic resonance imaging failed to demonstrate any evidence of recurrent disease in soft tissue or bone. The case is presented, and this very unusual presentation is discussed.

Minimizing urinary bladder radiation dose during brachytherapy for carcinoma of the cervix using balloon inflation technique.

PURPOSE: Radiotherapy is effective in treating cancer of the cervix. However, its success is associated with significant morbidity of the urinary bladder. This study has been designed to reduce the radiotherapy dose from the brachytherapy component of cervical cancer treatment to the urinary bladder to minimize radiation-induced morbidity. MATERIALS AND METHODS: By inflating the balloon of a Foley catheter at the anterior fornix region, attempts were made to displace the urinary bladder in patients undergoing gynecological intracavitary brachytherapy. The radiation dose to the urinary bladder was then studied in 12 insertions without and 31 insertions with balloon inflation. RESULTS: The increase in the distance from the intrauterine tandem source to a reference point in the base of the bladder and the resultant decrease in the radiation dose have been determined. A highly significant reduction in the radiation dose with an increase in distance between the source applicator and bladder base were achieved (p < 0.01 in both cases). CONCLUSION: A significant reduction in radiation dose to the bladder base can be achieved by the technique described in this study. A three-dimensional plan generated using CT images can demonstrate the drawback of ICRU-38 bladder reference point. The technique is simple consistent and reproducible within an acceptable range.

Age distribution of nasopharyngeal cancer in Saudi Arabia.

OBJECTIVE: The age standardized rate of head and neck cancer in the Kingdom of Saudi Arabia (KSA) is 5.7% with nasopharyngeal cancer (NPC) accounting for >40% of all head and neck cancers. This study intends to compare age specific incidence of NPC in KSA and other countries. METHODS: Data from the National Cancer Registry for KSA during the period 1994 through to 1996 was compared with data from the World Health Organization International Agency for Research on Cancer (ARC) in Singapore, China, Kuwait and Canada. RESULTS: There were 373 diagnosed Saudi patients with NPC with high incidence among the young population, with 42/373 (22 males/20 females) patients in the first 20 years of life, showing a sharp increase both in boys and girls until the ages of 12-14 years. From that point the incidence curve for both males and females separates. In females the incidence flattens without an identifiable zenith from the age of 12-14 years and above, compared with their male counterpart where they have another peak in the fifth decade. CONCLUSION: Our study indicates a definite early onset of this malignancy in KSA and a similar pattern to that of China and Singapore. Definite increased incidence, at a young age among both sexes, suggests a possible underlying genetic susceptibility in Saudis.

Treatment of earlobe keloids using the cobalt 60 teletherapy unit.

The purpose of this study was to develop an easily accessible technique for the delivery of postoperative radiotherapy for the treatment of earlobe keloids. Forty-seven earlobe keloids were given postoperative radiation using the smallest achievable half field Telecobalt technique. Results showed 41 (87.2%) of treated patients' postoperative scars remained free from recurrent keloid formation. Acute reactions were minimal and patient compliance was excellent. In conclusion, the technique described in this study for the delivery of postoperative radiation to earlobe keloids should be readily available in areas of high prevalence. Results are comparable to previously used radiotherapy techniques.