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S e p t e m b e r 2 0 - 2 1 , 2 0 1 8 | R o m e , I t a l y
Joint Event on
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
YEARS
Dermatology Congress 2018 & World Nephrology 2018 Archives of General Internal Medicine | ISSN: 2591-7951 | Volume 2
2nd WORLD NEPHROLOGY AND THERAPEUTICS CONGRESS
DERMATOLOGY AND TRICHOLOGY
&
International Congress on
Hassan Fouz et al., Arch Gen Intern Med 2018, Volume 2 | DOI: 10.4066/2591-7951-C5-014
NEO-ADJUVANT INTRALESIONAL
TREATMENT OF SCC WITH 5-FU: A CASE
REPORT
Hassan Fouz, Batoul, Kheirbek Majed and Ali Salim
Tishreen University, Syria
Introduction: This article documents a case of squamous cell carcinoma
(SCC) that was successfully reduced with intralesional 5-FU, thus providing a
possible treatment option for patients who are not good surgical candidates
or who prefer nonsurgical treatment.
Case Report: A female patient, 84 years old, with no history of past illnesses,
or comorbidities was studied. Six months ago, she was presented with two
masses on her face. These masses have experienced painless and gradual
growth in size over the past two years and have started to spread locally.
On physical examination, a white, greyish, irregular mass, measuring 3.5
cm x 1.5 cm was visible on the upper lip. Another mass was visible on the
left cheek. Also, two lymph nodes were palpable on both sides of the neck.
The rest of the examination was normal. The initial clinical diagnosis was
cutaneous SCC. Then, an incisional biopsy was taken and confirmed the
diagnosis of SCC, grade II. CT (computed tomography) of the neck showed
lymphadenopathy in two nodes measuring 1 cm and 7 mm. CT of the chest
revealed calcifications in the upper and middle lobes of the left lung. CT of
the abdomen, and pelvis, full blood count, and liver and renal functions were
normal. After consulting with the surgeon; neoadjuvant chemotherapy was
planned to reduce the mass to facilitate the excision. The patient underwent
five sessions of intralesional 5-FU 50 mg. Each session consisted of injecting
the lesion with equal amounts of 5-FU in 4-5 separate sites. The sessions were
one week apart. After each session, a reduction in the size of the tumour was
noted. Throughout the chemotherapy cycles, all haematological parameters
were stable, and no serious adverse effects were observed. After finishing
the chemotherapy, the tumour diminished tremendously, and the patient was
sent for surgery.
Result & Discussion: In this case report, our patient received five weekly
injections of 5-FU. The total amount of drug received over the five weeks was
250 mg, resulting in a considerable reduction of the cancer, thus becoming
a better candidate for skin-sparing surgery. These results along with the
proven use of 5-FU in treating lesions related to SCC, demand that further
studies should be done on the effectiveness and dosing of intralesional 5-FU
in treating SCC. This modality may eventually provide patients with SCC in
cosmetically important locations or in areas that require complex surgery the
advantage of a nonsurgical cure or a minimally invasive surgery.
Hassan Fouz is a Syrian Dermatologist, she is a Pro-
fessor at Tishreen University and head of department
of Dermatology and Venereology Tishreen University
hospital.
BIOGRAPHY