Archives of General Internal Medicine

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NEO-ADJUVANT INTRALESIONAL TREATMENT OF SCC WITH 5-FU: A CASE REPORT

Joint Event on International Congress on DERMATOLOGY AND TRICHOLOGY & 2nd WORLD NEPHROLOGY AND THERAPEUTICS CONGRESS
September 20 - 21, 2018 | Rome , Italy

Hassan Fouz, Batoul, Kheirbek Majed and Ali Salim

Tishreen University, Syria

Scientific Tracks Abstracts : Arch Gen Intern Med

DOI: 10.4066/2591-7951-C5-014

Abstract:

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.

Biography:

Hassan Fouz is a Syrian Dermatologist, she is a Professor at Tishreen University and head of department of Dermatology and Venereology Tishreen University hospital.

E-mail: fozsaid2@gmail.com

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