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Liu KH, Shao KY. Intraoral myoepithelial carcinoma in a young man with intellectual disability: A highly rare and challenging case. J Dent Sci 2024; 19:1888-1889. [PMID: 39035287 PMCID: PMC11259641 DOI: 10.1016/j.jds.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/12/2024] [Indexed: 07/23/2024] Open
Affiliation(s)
- Ke-Hsuan Liu
- Oral-Maxillofacial Surgery Division, Department of Dentistry, Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Kung-Yu Shao
- Oral-Maxillofacial Surgery Division, Department of Dentistry, Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
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Lesage C, Habib-Hadef S, Trétarre B, Lesage FX, Bessaoud F, Varey E, Guillot B, Satgé D. Melanoma and intellectual disability: do prognostic factors at diagnosis differ from general population? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:392-398. [PMID: 35137477 DOI: 10.1111/jir.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 11/21/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Few melanoma cases are reported in individuals with intellectual disability (ID), and prognostic factors at diagnosis are unknown in this population. This work was designed to investigate whether prognostic factors at diagnostic are different in patients with ID compared with a general population. METHODS Melanoma cases retrieved from Hérault's Tumour Registry (HTR) from 1995 to 2015 were cross-referenced against a list of adult patients with ID, living in Hérault. Major prognostic factors were compared with those in non-ID melanoma patients included in HTR and in patients followed by Montpellier University Hospital and included in the Réseau pour la Recherche et l'Investigation Clinique sur le Mélanome (RIC-Mel) database. RESULTS Ten melanoma cases in individuals with ID were identified and compared with 3804 non-ID melanoma cases in HTR and 1024 non-ID melanoma cases included in RIC-Mel. Mean Breslow thickness at diagnosis was 4.6 mm in melanoma cases among those with ID versus 1.89 mm in HTR (P = 0.109) and 2.36 mm in RIC-Mel (P = 0.156). Stage at diagnosis was superior to stage IIB in 42.9% of ID cases versus 11.4% of non-ID cases in HTR (P < 0.05) and 8.5% in RIC-Mel (P < 0.05). CONCLUSIONS Melanomas in patients with ID had less favourable prognostic factors at diagnosis, including higher Breslow thickness and more advanced stage, than melanomas in non-ID patients. These adverse prognostic factors indicate a later diagnosis in this population, leading to a poorer prognosis. This work underlines the need to improve melanoma screening among individuals with ID.
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Affiliation(s)
- C Lesage
- Department of Dermatology, University Hospital, Montpellier, France
| | | | - B Trétarre
- Registre des Tumeurs de l'Hérault, Montpellier, France
| | - F-X Lesage
- Department of Professional pathologies, University of Montpellier, University Hospital Montpellier, Montpellier, France
| | | | - E Varey
- Réseau pour la Recherche et l'Investigation Clinique sur le Mélanome, Nantes University Hospital, Nantes, France
| | - B Guillot
- Department of Dermatology, University Hospital, Montpellier, France
| | - D Satgé
- ONCODEFI, Montpellier, France
- Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM Univ. Montpellier, Montpellier, France
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Cancer treatment and decision making in individuals with intellectual disabilities: a scoping literature review. Lancet Oncol 2022; 23:e174-e183. [DOI: 10.1016/s1470-2045(21)00694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
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Satgé D, Axmon A, Trétarre B, Sandberg M, Ahlström G. Cancer diagnoses among older people with intellectual disability compared with the general population: a national register study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:579-588. [PMID: 32395851 DOI: 10.1111/jir.12734] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Cancer occurrence among older people with intellectual disability (ID) is poorly documented, so we investigated the frequency and distribution of cancer in older people with ID compared with the general population. METHOD People with ID who were ≥55years old and alive at the end of 2012 (n = 7936; ID cohort) were identified through a national register of people with ID who received social services in Sweden to optimise the individual's opportunity for good living conditions in daily life. An equally large reference cohort from the general population (gPop cohort) was matched by year of birth and sex. Cancer diagnoses registered in inpatient and outpatient specialist care were collected for 2002-2012 from the ID cohort and compared with diagnoses in the gPop cohort. RESULTS A lower total cancer frequency was observed in the ID cohort, which contained 555 cancers, compared with 877 cancers in the gPop cohort [odds ratio (OR): 0.63; 95% confidence interval (CI): 0.57-0.70]. Women accounted for 60% of cancers in the ID cohort. Breast and gynaecological organ cancers had similar or slightly lower frequencies in the ID cohort than in the general population, with breast OR of 0.95, uterine corpus OR of 1.00 and ovary OR of 0.73. Surprisingly, cancer frequency of the digestive organs (OR: 0.67), including the colon (OR: 0.82), was lower than in the general population. Cancers of the prostate (OR: 0.25), urinary tract (OR: 0.42) and lung were less frequent than in the general population. CONCLUSIONS Cancer was diagnosed less frequently in the ID cohort than in the gPop cohort. However, cancers of the breast and colon-rectum remain frequent in people with ID and therefore warrant prevention policies, monitoring and screening similar to those of the general population.
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Affiliation(s)
- D Satgé
- Department of Biostatistics, Institut Universitaire de Recherche Clinique (IURC) Team Cancer Epidemiology, Montpellier, France
- Oncodéfi, Montpellier, France
| | - A Axmon
- EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - B Trétarre
- Department of Biostatistics, Institut Universitaire de Recherche Clinique (IURC) Team Cancer Epidemiology, Montpellier, France
- Oncodéfi, Montpellier, France
- Registre des Tumeurs de l'Hérault, Montpellier, France
| | - M Sandberg
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - G Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Millard SK, de Knegt NC. Cancer Pain in People With Intellectual Disabilities: Systematic Review and Survey of Health Care Professionals. J Pain Symptom Manage 2019; 58:1081-1099.e3. [PMID: 31326504 DOI: 10.1016/j.jpainsymman.2019.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Owing to life expectancy improvements for people with intellectual disabilities, their risk of developing cancer is increasing. Pain is an inevitable aspect of cancerous diseases. However, as pain experience and expression can be atypical in people with intellectual disabilities, this population is vulnerable to late diagnosis of cancer and undertreatment of cancer pain. OBJECTIVES The objective of this study was to investigate what is currently known about cancer pain in people with intellectual disabilities and provide specific recommendations to improve this knowledge. METHODS A systematic review using PubMed, PsycINFO, and CINAHL and an anonymous online survey of Dutch health care professionals were conducted. RESULTS From 10,146 publications, with intellectual disabilities in the title, and pain or cancer in the title or abstract, 11 articles underwent qualitative synthesis. Discussions within these articles were predominantly unspecific and brief, frequently indicating challenges in symptom presentation, communication, as well as assessment and treatment of cancer pain. The survey received 102 responses. The 63 health care professionals experienced with cancer in people with intellectual disabilities indicated challenges recognizing, assessing, and treating their cancer pain. CONCLUSION Cancer pain in people with intellectual disabilities is a topic lacking specific and comprehensive research within scientific literature. We suggest this is due to inherent difficulties regarding the complex interplay of comorbidities and communication issues in people with intellectual disabilities.
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Affiliation(s)
- Samantha K Millard
- Institute for Interdisciplinary Studies, Universiteit van Amsterdam (UvA), Amsterdam, the Netherlands.
| | - Nanda C de Knegt
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam (VU), Amsterdam, the Netherlands
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Central mucoepidermoid carcinoma: An up-to-date analysis of 147 cases and review of prognostic factors. J Craniomaxillofac Surg 2017; 46:162-167. [PMID: 29198377 DOI: 10.1016/j.jcms.2017.10.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/26/2017] [Accepted: 10/24/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To integrate the available data published on central mucoepidermoid carcinoma (CMC) into a comprehensive analysis of its clinical aspects, histology, treatment, and prognostic factors. METHODS An electronic search was undertaken in July 2017. Eligibility criteria for publications included having clinical, histological, treatment, and time of follow-up data to confirm the diagnosis. RESULTS In addition, gender, histological grade, conservative treatment, and lymph node metastasis were significant independent prognostic factors. CONCLUSION Male patients with histological grade III CMC of the jaw bone, who used conservative treatment as the main treatment, and presented with lymph node metastasis, were more likely to have a worse prognosis.
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Abstract
Fragile X syndrome (FXS), a leading cause of inherited intellectual disability, most commonly results from an expansion of the CGG trinucleotide repeat in the fragile X mental retardation 1 (FMR1) gene to more than 200 copies (full mutation). The FXS phenotype differs by sex and is associated with intellectual and cognitive impairment, characteristic physical features, epilepsy, and/or behavioral challenges including autism spectrum disorder. In this patient population, tumors involving blood cells, digestive organs, the central nervous system, and testes have been described, but melanocytic tumors have not been reported. Here, we describe two maternal cousins with FXS, one of whom has melanoma and the other has atypical nevus syndrome. We discuss possible mechanisms leading to this unusual or possibly coincidental association and the difficulties in the optimal treatment of FXS patients.
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Challenges in Diagnosis and Treatment of Lung Cancer in People with Intellectual Disabilities: Current State of Knowledge. LUNG CANCER INTERNATIONAL 2016; 2016:6787648. [PMID: 27752368 PMCID: PMC5056278 DOI: 10.1155/2016/6787648] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/17/2016] [Accepted: 09/04/2016] [Indexed: 11/22/2022]
Abstract
As the life expectancy of people with intellectual disability (ID) has progressed, they have become similarly at risk of cancer as individuals of the general population. Epidemiological studies indicate a reduced incidence and mortality from lung cancer in the total population of persons with ID. However, the pattern is heterogeneous and the risk is strongly correlated with the impairment level; persons with mild intellectual impairment have higher cancer risk, and this subgroup also has the highest tobacco consumption (the major risk factor for lung cancer) compared to individuals with more severe impairment. Clinical presentation of lung cancer in persons with ID is often atypical, with symptoms frequently hidden by the mental state and communication impairments. Treatment can be impeded by incomplete understanding and lack of cooperation on the part of the patient; nevertheless, general principles for treating lung cancer must be applied to persons with ID. Early diagnosis and implementation of an adapted treatment plan may result in lung cancer outcomes similar to those of individuals in the general population. Physicians facing the difficult task of treating lung cancer in persons with ID are called to carry out their mission of care in a responsible, free, and creative way.
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Sawan D, Mashlah A. Evaluation of premalignant and malignant lesions by fluorescent light (VELscope). J Int Soc Prev Community Dent 2015; 5:248-54. [PMID: 26236687 PMCID: PMC4515810 DOI: 10.4103/2231-0762.159967] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim: The purpose of this study was the early detection of premalignant and malignant oral soft lesions by fluorescent light (VELscope). Materials and Methods: A total of 748 patients were evaluated through clinical and fluorescent light analysis of the entire oral cavity. Any lesion that was detected underwent a surgical excision biopsy as the golden standard for the detection of the lesion's histology; then a comparison was made between the results to assure the efficacy of the fluorescent light analysis outcome. Results: About 9.4% of the lesions detected were abnormal lesions and 83.09% had loss of fluorescent light effect. Based on the use of surgical biopsy, the machine had a sensitivity of 74.1% and a specificity of 96.3%. According to the statistical analysis, the P value was much lower than 0.05, so we can conclude that at 95% confidence level, there was significant agreement between VELscope results and biopsy results. Kappa coefficient value was approximately 0.5, which means that the strength of the agreement was medium. Conclusion: VELscope can be used as a clinical diagnostic aid in the detection of premalignant and malignant lesions of the oral cavity. In addition, it helps in the detection of the borders in both surgical biopsy and surgical excision.
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Affiliation(s)
- Dania Sawan
- Department of Oral Medicine, Damascus University, Damascus, Syria
| | - Ammar Mashlah
- Department of Oral Medicine, Damascus University, Damascus, Syria
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Enomoto A, Nakatani T, Morikage E, Shimoide T, Hamada S. Tongue cancer with mental retardation due to microcephaly: a clinical report. World J Surg Oncol 2015; 13:216. [PMID: 26179630 PMCID: PMC4504062 DOI: 10.1186/s12957-015-0634-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/25/2015] [Indexed: 11/10/2022] Open
Abstract
Oral cancer in patients with mental retardation has not been reported in detail, although the literature on clinical management of oral malignancies in the general population is extensive. No clear consensus has been established regarding the management of oral cancer in patients with mental retardation. We present herein the case of a 32-year-old Japanese man with mental retardation due to microcephaly who presented with advanced tongue cancer. He was treated with three courses of chemotherapy using superselective intra-arterial infusion of cisplatin at 100 mg/m2 via the femoral artery (Seldinger method). No major complications were encountered, and complete response was achieved. The patient has shown no clinical or radiological evidence of local recurrence or distant metastases as of 22 months after the end of treatment. This case provides a basis for the future appropriate management of oral cancer in patients with mental retardation.
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Affiliation(s)
- Akifumi Enomoto
- Department of Oral and Maxillofacial Surgery, Kinki University School of Medicine, 377-2, Onohigashi, Osaka-Sayama, 589-8511, Japan.
| | - Takanori Nakatani
- Department of Oral and Maxillofacial Surgery, Kinki University School of Medicine, 377-2, Onohigashi, Osaka-Sayama, 589-8511, Japan.
| | - Eri Morikage
- Department of Oral and Maxillofacial Surgery, Kinki University School of Medicine, 377-2, Onohigashi, Osaka-Sayama, 589-8511, Japan.
| | - Takeshi Shimoide
- Department of Oral and Maxillofacial Surgery, Kinki University School of Medicine, 377-2, Onohigashi, Osaka-Sayama, 589-8511, Japan.
| | - Suguru Hamada
- Department of Oral and Maxillofacial Surgery, Kinki University School of Medicine, 377-2, Onohigashi, Osaka-Sayama, 589-8511, Japan.
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