Myiasis on a Giant Squamous Cell Carcinoma of the Scalp: A Case Report and Review of Relevant Literature

Biswas, Saptarshi; McNerney, Patrick

doi:10.14740/wjon966w

Cited by 11 publications

(34 citation statements)

References 46 publications

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“…4 Another report described a rare case of cutaneous myiasis located on a giant squamous cell carcinoma of the scalp in a 95 year old female who underwent radiation of 5,000-6,000 cGy in 24 daily fractions, without reporting of outcomes. 33 To our knowledge, this retrospective study is the first to analyze the outcomes of giant NMSCs not amenable to surgery in a substantial group of older frail patients treated with definitive 3D CRT, demonstrating its feasibility and effectiveness in both curative and palliative settings.…”

Section: Discussionmentioning

confidence: 86%

Electron beam radiotherapy in giant non- melanoma skin cancers of the head in elderly inoperable patients: a single centre retrospective study

Lazzari¹,

Perri²,

Vittoria³

et al. 2020

JCPCR

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Background: Electron beam three-dimensional conformal radiotherapy (3D-CRT) may be an alternative effective option for the treatment of giant nonmelanoma skin cancers (NMSCs) of the head in older patients unfit for surgery. Here, we present a retrospective study of older patients with giant NMSCs of the head treated with 3D-conformal electron beam radiotherapy, including analysis of clinical outcomes and factors impacting local control.Materials and methods: Fifty older patients with sixty T3-T4 giant and aggressive NMSC lesions of the head, irradiated between 2005 and 2015, were retrospectively studied. Treatment consisted of one or two fields of customized electron beams planned using 3D conformal radiotherapy. Univariate analysis with Chi-square, Cox proportional hazard ratio, and Pearson's covariance for multivariate analyses, assuming P<0.05 for statistical significance, were used to assess the impact of clinical and dosimetric parameters on local control.Results: Complete response (CR) occurred in 15 patients and 25 lesions. Bleeding control was obtained for all symptomatic lesions. Cumulative local progression free survival rates at 2 and 5 years were 85% and 78%, respectively. On univariate analysis several factors were found to significantly impact local progression, including diabetes (P<0.001) and primary site (P<0.03), with scalp being significant for durable local control (P<0.02). On multivariate analysis, both factors were confirmed as significant prognostic indicators of local control. Treatment was well-tolerated with acceptable acute and late toxicity and good palliation effect. Conclusion:Customized electron beam 3D CRT for giant NMSCs of the head not amendable to surgery in frail older patients can be considered an effective and safe option in both curative and palliative settings.

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Section: Discussionmentioning

confidence: 86%

Electron beam radiotherapy in giant non- melanoma skin cancers of the head in elderly inoperable patients: a single centre retrospective study

Lazzari¹,

Perri²,

Vittoria³

et al. 2020

JCPCR

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“…1). 5–7,17–104 A case series of Sowani et␣al 98 . with 83 patients was excluded from our study due to severe limitations in the eligibility methods, lack of precision in the clinical findings, and lack of histopathological confirmation.…”

Section: Resultsmentioning

confidence: 99%

“…The species classification can also vary according to its biological feeding behavior. The reader must be careful with the biological behavior of the larvae in tumor wounds 1–11,13–114 …”

Section: Introductionmentioning

confidence: 99%

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Cutaneous myiasis in skin cancer and malignant wounds: a systematic review

et al. 2021

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Background Cutaneous myiasis in patients with malignant wounds or skin cancer is a rare and undesirable event with limited epidemiological data. A subregister of reports, lack of education in the population, inadequate empirical treatments, and medical underestimation are components of a public health problem that threatens patients' lives. Methods We conducted a systematic review of the literature of cutaneous myiasis associated with malignant wounds and skin cancer, characterizing sociodemographic variables, risk factors, clinical and histological features, and treatment. Additionally, we present a demonstrative case with the adequate taxonomic evaluation. Discussion Cutaneous myiasis is an underestimated and poorly managed infestation, which can generate severe complications in oncological patients. This is the first systematic review in the literature about this clinical scenario, which provides information to the physician and clinical researcher about the epidemiological gaps and what has been published so far. Conclusions Findings from the current review have helped to display the sociodemographic, epidemiological, and clinical behavior of myiasis in skin cancer and malignant wounds. Its contribution to the greater tumor tissue destruction is clear; however, more studies are required. The therapeutic management in these patients is equally clarified.

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“…Studies have reported that symptomatic improvement occurs immediately with the removal of the larvae. [ 28 ] Ivermectin given orally in just one dose of 150–200 mcg/kg body weight and repeated after 24 h has been reported to be effective in severe cases. [ 29 ] Shinohara et al .…”

Section: Discussionmentioning

confidence: 99%

Management of malignant wound myiasis with ivermectin, albendazole, and clindamycin (triple therapy) in advanced head-and-neck cancer patients: A prospective observational study

Patel¹,

Ostwal²,

Sanghavi³

et al. 2018

Indian J Palliat Care

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Introduction:Myiasis, tissue infestation by housefly larvae, is commonly found in malignant fungating wounds of cancer patients from climatic condition and lower socio-economic strata.Aim of study:It was aimed to study the effectiveness of systemic Ivermectin, Albendazole& Clindamycin (Triple Therapy) in reducing signs & symptoms associated with maggots in malignant head and neck wounds.Method:25 adult, advanced head and neck cancer patients presenting with maggots either from wound, oral cavity or nostril, with ECOG score 3 or less were enrolled in this study. Symptoms were assessed using Edmonton Symptom Assessment Scale (ESAS) and wound by Wound Assessment Tool – Hospice, at baseline and then Days 1, 3, 5, and 7. All patients received 3 days course of oral Ivermectin 12 mg per day, Albendazole 400 mg twice per day and Clindamycin 300 mg three times per day for 5 days along with Terpentine oil dressing. All patients received oral Morphine as per their pain score.Results:Mean age (yrs) and weight (Kg) were 42.15 ± 8.23 and 52.31 ± 5.18 respectively. 84% patients were male. Mean oral morphine dose was 100.38 mg. There was significant decrease in number of maggots from day 0 (77.28 ± 13.465) to day 1 (20.60 ± 7.263; 73.34% reduction) to day 3 (1.52 ± 2.104; 92.62% reduction). We found statistically significant improvement (P = <0.05) in scores of wound and all other related symptoms on days 1, 3, 5 & 7, except bleeding, edema, nausea, anxiety, appetite loss and feeling of wellbeing, which remained same on Day 1, but improved afterward. Side effects were self-limiting.Conclusion:Systemic treatment with Ivermectin, Albendazole and Clindamycin (Triple Therapy) enhances the removal of maggots, early recovery and relief from distress and associated symptoms.

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Myiasis on a Giant Squamous Cell Carcinoma of the Scalp: A Case Report and Review of Relevant Literature

Cited by 11 publications

References 46 publications

Electron beam radiotherapy in giant non- melanoma skin cancers of the head in elderly inoperable patients: a single centre retrospective study

Electron beam radiotherapy in giant non- melanoma skin cancers of the head in elderly inoperable patients: a single centre retrospective study

Cutaneous myiasis in skin cancer and malignant wounds: a systematic review

Management of malignant wound myiasis with ivermectin, albendazole, and clindamycin (triple therapy) in advanced head-and-neck cancer patients: A prospective observational study

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