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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Cutaneous Metastasis of Squamous Cell Carcinoma of the Tongue as Bilateral Neck Nodules: A Case Report
Correspondence Address :
Dr. Suraj Madhavan Nair,
Lakshminivas, Kottayam-686532, Kerala, India.
E-mail: surajmadhu50@gmail.com
Squamous Cell Carcinoma (SCC) of the oral cavity is one of the most common malignancies in the head and neck region. Although lymphatic spread is the most common mode of metastasis, it can also metastasise via the haematogenous route to internal organs such as the lungs, liver and bones. While cutaneous metastasis has been reported in SCC of the oral cavity, metastasis presenting as subcutaneous nodules on both sides of the neck is extremely uncommon. Hereby, authors present a 66-year-old male with a history of smoking and diabetes, diagnosed with well-differentiated SCC of the tongue. He underwent wide local excision, selective neck dissection and adjuvant radiation therapy. He developed a recurrence in the level V cervical lymph nodes after one year, which was surgically excised. Histopathology confirmed metastasis in all the nodes, with two showing extranodal extension. A few weeks later, patient presented with painful, umbilicated skin nodules on both sides of the neck. A biopsy confirmed these as cutaneous metastasis from SCC. This case details a unique presentation of SCC of the tongue, which relapsed as painful subcutaneous nodules on both sides of the neck, highlighting the varied clinical presentation, diagnostic approach and pathological findings.
Metastasise, Ulceroproliferative, Umbilicated nodules
A 66-year-old male patient, known to be diabetic and a former smoker, presented with an ulceroproliferative lesion measuring 2.2×1.5×0.7 cm on the anterior two-thirds of the tongue at the left lateral border. A biopsy confirmed a tissue diagnosis of well-differentiated SCC. A clinicoradiological stage of cT2N0M0 was confirmed with a metastatic work-up. As per the multidisciplinary tumour board's decision, he underwent wide local excision with primary closure and selective neck dissection of the same side, levels I-IV. Histopathology confirmed the diagnosis of SCC (grade 1). All resected margins were free of neoplasm, but perineural and lymphovascular invasions were present. One out of 14 dissected lymph nodes showed metastasis. The pathological stage was pT2N1Mx. Adjuvant radiation of 60 Gy in 30 fractions was administered for the primary site and neck.
After a year of disease-free interval, he presented with enlarged left level V cervical neck nodes. An Fluorodeoxyglucose Positron Emission Tomography Contrast-enhanced Computed Tomography (FDG PET CECT) scan revealed this as the only site of disease; hence, he underwent completion radical neck dissection and was found to have infiltration of the sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve, and surrounding muscles by the neck nodal mass. Histopathological review confirmed an SCC recurrence with extranodal extension. After four weeks, he presented with multiple umbilicated and tender skin nodules on the anterior aspect of the neck (Table/Fig 1). Fine Needle Aspiration Cytology (FNAC) aspirated a light brown fluid of less than 0.5 mL. Smears revealed predominantly atypical squamous cells in a background of suppuration, favoring a diagnosis of SCC (Table/Fig 2). An incisional biopsy was performed to confirm the diagnosis of SCC and to exclude the possibility of other primary cutaneous or appendage tumours and keratoacanthoma. Microscopy confirmed infiltrating SCC (Table/Fig 3). He was started on palliative chemotherapy; however, the patient developed many similar nodules on the anterior and lateral sides of the neck (Table/Fig 4). His general condition continues to deteriorate.
Oral cavity cancer, which includes carcinoma of the tongue, floor of the mouth, gums and lips, is the most common cancer in the head and neck region (1). SCC is the most common histological variant. Direct extension and invasion of adjacent structures (80-90%) and lymphatic spread (50-70%) are the common modes of spread for this tumour. In advanced cases of SCC, haematogenous dissemination occurs, with common sites being the lungs, liver, bones, brain, kidneys, adrenal glands, pancreas and skin, in decreasing order of frequency (2). Metastatic subcutaneous nodules are reported in approximately 2-5% of cases of SCC of the tongue (3). The present patient presented with multiple dome-shaped skin nodules in the neck after a span of one year following the diagnosis and treatment. Fine Needle Aspiration Cytology (FNAC) and biopsy from the nodules confirmed metastatic deposits. Radiological evaluation excluded other metastatic foci.
Cutaneous metastasis is a significant marker of advanced disease and poor prognosis. The morphological spectrum of skin metastases includes asymptomatic papulonodules, erysipeloid, sclerodermoid and zosteriform lesions. Rarely, they may present with a keratoacanthoma-like morphology, as observed in the present case. Keratoacanthoma and SCC have strong clinical and histological similarities. Keratoacanthoma appears as a slowly growing single lesion in sun-exposed areas, is not painful, and can spontaneously resolve (4). In the present case, the lesions were multiple, painful, and new lesions appeared continuously. Post-irradiation nodules were also listed in the differential diagnosis; however, they can be distinguished by histology.
This unusual form of cutaneous metastasis raised suspicion of Carcinoma Encrasse (CeC) (5). Differentiating metastatic bilateral nodules from CeC is a diagnostic challenge in most cases. CeC is an abnormal skin metastasis that can present in varying forms, such as nodular, sclerodermatiform, or papular, which develops following radiation or chemotherapy. In contrast, metastatic bilateral nodules are smaller, often less than 2 cm, and are symmetrically distributed on both sides of the neck (5). The clinicomorphological features favoured the diagnosis of bilateral synchronous metastasis in the present case. CeC is most commonly reported in association with breast and lung carcinoma, with other sites including the colorectum, kidney, ovary, and head and neck.
Lymph node metastasis is a critical prognostic indicator for oral and oropharyngeal carcinomas (6). The most common site for carcinoma metastasis is the cervical lymph nodes, and this can reduce the survival rate by 50%. Cancer cells usually spread to the lymph nodes on the same side as the primary tumour; however, contralateral or bilateral lymph node metastasis is rare. In histopathology, tumour cell dissemination outside the lymph node capsule worsens the prognosis and reduces patient survival rates.
Early nodal metastasis, multiple lymphovascular emboli, and extranodal extension might have led to an early recurrence in the present case patient, although all the surgical margins were clear. Marked perineural invasion explains the excruciating pain that the patient experienced.
Cutaneous metastasis is associated with a poor prognosis, with an average survival time of less than a year (7). Treatment for most of these patients is palliative, and although chemotherapy and radiotherapy are often used, they have a limited impact on survival in many cases (8).
The present case highlights the significance of certain unusual patterns of cutaneous metastasis, with CeC being one of them. Any unexplained skin lesion should, therefore, be evaluated carefully and promptly biopsied, as timely diagnosis significantly improves patient prognosis. Awareness of such rare metastatic patterns is crucial for accurate diagnosis, appropriate management and prognosis prediction. Further studies are warranted to understand the mechanisms and clinical implications of cutaneous metastases in SCC.
DOI: 10.7860/JCDR/2025/75855.20721
Date of Submission: Oct 01, 2024
Date of Peer Review: Oct 24, 2024
Date of Acceptance: Dec 06, 2024
Date of Publishing: Mar 01, 2025
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 03, 2024
• Manual Googling: Nov 21, 2024
• iThenticate Software: Dec 04, 2024 (5%)
ETYMOLOGY: Author Origin
EMENDATIONS: 5
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
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- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com