Middle East Journal of Cancer
Volume:13 Issue: 2, Apr 2022

Thyroid cancer is highly common all around the world. Its prevalence has rapidly increased over the last 30 years in the United States and other developing countries. Fine-needle aspiration biopsy has become the cornerstone of thyroid nodule diagnosis, whose general reliability is outstanding; however, some aspirates have shown undetermined cytological findings that do not provide a definitive malignancy diagnosis. At least 70 molecular and genetic markers in thyroid nodules have been analyzed in an effort to identify molecular markers to differentiate malignant and benign (BN) thyroid nodules. The present review focused on the currently used markers in thyroid cancer diagnosis. A rising number of studies have investigated immunohistochemical markers, such as galectin-3 (GAL3), cytokeratin 19 (CK19), hector battifora mesothelial- 1 (HBME-1), and thyroid peroxidase, along with DNA alterations, including mainly BRAF (B-Raf proto-oncogene, serine/threonine kinase) and RAS (Ras proto-oncogene, GTPase) point mutations, Telomerase reverse transcriptase mutations, ret protooncogene/ papillary thyroid carcinoma and PAX8/PPARG rearrangements, and miRNA signatures and circulating tumor cells for thyroid cancer diagnosis. Although certain markers are promising for differential diagnosis, due to limitations of the substantial prevalence of BN thyroid tumors, none of them is specifically definitive to a large extent. Herein, we also discussed the studies that have supported the use of combinations of several markers, like KIT, TC1, miR-222, and miR-146b combination, as well as GAL3, CK19, and HBME-1 combination, in enhancing the diagnostic accuracy in differentiating malignant and BN tumors.

Homeodomain transcriptional regulatory proteins, which are encoded by Homeobox (HOX) genes, play critical roles in both normal development and carcinogenesis. Previous studies have shown that the expression of HOX genes is deregulated in numerous tumors and this expression is specific to each cancer based on the arising embryonic origin tissue and the site of tumor.

In this in vitro study, the expression levels of HOXA10, CDX1, CDX2, TGIFLX, TGIFLY, and OCT1 genes were compared across 10 different human colorectal cancer cell lines with different differentiation stages. Subsequently, the effect of TGIFLX siRNA-mediated knockdown on the expression levels of CDX1, CDX2, and OCT1 genes was analyzed in SW948 cell line.

The obtained results revealed that these homeobox genes were differentially expressed in different colorectal cancer cell lines. Furthermore, the siRNA-mediated knockdown of TGIFLX led to higher levels of CDX1, CDX2, and OCT1 expression.

Our data suggested that TGIFLX plays an important role in the upstream regulation of CDX1, CDX2, and OCT1 genes.

Breast cancer is known to be one of the most prevalent malignancies in women worldwide. Umbelliprenin (UMB) is a naturally-occurring component derived from plant species, which has shown anticancer properties. The present study aimed to evaluate the effect of UMB on the PI3K / Akt / ERK signaling pathway and their products HIF-1α / VEGF in the MDA-MB-231 cell line.
In this experimental study, the cytotoxic effect of UMB on MDA-MB- 231 cells was evaluated using the MTT assay and the UMB concentrations of IC5 and IC10 were selected for the signaling pathway study. MDA-MB-231 cells were stimulated with EGF and CoCl2 and UMB IC5 and IC10 effects on gene expression and translation was studied. PI3K / Akt / mTOR / S6K / Erk1 and 2 / 4E-BP1 / HIF-1α / HIF-1α/ EGFR / VEGFR and VEGF mRNA expression, and VEGF / HIF-1α proteins were evaluated employing real time polymerase chain reaction and western blot analysis, respectively.
The concentrations of UMB in IC10 and IC5 were 20 and 10 μM, respectively. UMB, specifically IC10, significantly inhibited PI3K, ERK1, ERK2, Akt, mTOR, HIF1-α, HIF1-β mRNA, as well as HIF-1α and VEGF protein expression.
Our results suggested that UMB, a cytotoxic agent, inhibits PI3K / Akt / ERK signal pathway in the CoCl2 or EGF-stimulated MDA-MB-231 cells.

Gankyrin is an oncoprotein incriminated in cancer growth, invasion, and spread. Snail1 is associated with mesenchymal features acquisition that is related to invasion and metastasis of malignant cells. Isocitrate dehydrogenase 1(IDH1) has been found to be mutated in several cancers, which leads to altered cellular metabolism and tumorgenesis. The present study aimed to assess Gankyrin, Snail1, and IDH1 expression patterns and compare them to clinicopathological and prognostic parameters. In our prospective cohort study, the samples taken from 60 renal cell carcinoma (RCC) patients were processed, diagnosed, graded, staged, and subjected to immunohistochemistry for Gankyrin, Snail1, and IDH1. The patients were chosen, treated, and followed up from January 2015 to December 2019. Overall survival (OS) and progression-free survival (PFS) were assessed. High expression levels of Gankyrin were positively associated with high grade (P = 0.003), stage (P = 0.033), and size of the tumor (P = 0.049), in addition to lymph nodes metastasis (P = 0.01), distant metastases (P = 0.007), higher incidence of tumor progression, unfavorable 5-year PFS, and OS rates (P < 0.001). High expression levels of Snail1 were positively associated with high grade (P = 0.004) and stage (P = 0.023) of the tumors, on top of lymph nodes metastasis (P = 0.003), distant metastases (P = 0.002), higher incidence of tumor progression, poorer fiveyear PFS, and OS rates (P < 0.001). High expression levels of IDH1 were negatively associated with low grade (P = 0.002), stage, and size of the tumor and lymph nodes metastasis (P < 0.001), distant metastases (P = 0.041), lower incidence of tumor progression (P = 0.013), better five-year PFS, and OS rates (P < 0.041). We indicated the associations between poor RCC pathological parameters, unfavorable patients’ outcome, high Gankyrin, high Snail1, and reduced IDH1 expression.

Programmed death- ligand 1(PD-L1) acts as an immune checkpoint inhibitor. Phosphatase and tensin homolog (PTEN) is a somatically mutated tumor suppressor gene in numerous types of human cancer. The current study aimed to assess the prognostic value of PD-L1 and PTEN expression in prostatic cancer patients, as well as their relationship with the clinicopathological features of the disease.
A total of 55 needle biopsy specimens were retrospectively diagnosed as prostatic adenocarcinoma. Immunohistochemical staining with PD-L1 and PTEN were evaluated in all the cases. The patients were followed up for 5 years in order to detect disease recurrence and survival.
PD-L1 expression in Prostate cancer was positively correlated with high prostatic specific antigen (PSA), higher Gleason score, advanced stage, higher tumor relapse, and worse disease-free and overall survival (P < 0.001). PTEN loss was significantly associated with high PSA, higher Gleason score < 7, advanced tumor stage, tumor relapse, and worse disease-free and overall survival (P < 0.001). We observed a significant negative correlation between PTEN and PD-L1.
PDL-1 and PTEN are prognostic markers for prostate cancer, which can differentiate between the patients who are at a high risk of disease progression and may successively provide novel targeted therapies.

Tumor microenvironment, specifically tumor-associated macrophages, plays an important role in tumor initiation and progression. CD163 has been recognized as a valuable specific macrophage marker. Cyclooxygenase-2 (Cox2) plays a role in tumor progression. CD31 is reliable for estimation of the density of microvesseles (MVD), which has prognostic importance in several malignant tumors. Thus, the current study was conducted to test the association between CD163, Cox2, and CD31 expression with the prognosis of classical Hodgkin lymphoma (cHL) patients and their potential correlation with clinicopathological variables.
CD163, Cox2, and CD31 expressions were examined in newly diagnosed patients with cHL through immunohistochemistry on tissue biopsy and the results were correlated with the patients’ outcome after the median follow-up, which was about 35 months.
104 patients were included in this study. High CD163 was found in 32.7% of the patients. Cox2 was positive in 42.3% of them. CD 31 with high MVD (≥10%) was found in 51% of the subjects. A significant association was detected between CD163 and Cox2 with tumor stage (P = 0.001, and P = 0.001) and IPS score. Regarding CD31, we could not find any significant associations with disease parameters, except with histological subtype (P = 0.001). A significant relationship was observed between Cox2 and CD163 expression and the relapse rate (P = 0.001, P = 0.01, respectively). Regarding survival, only Cox2 showed a significant association with disease-free survival (P = 0.0379).
These findings suggested that Cox2 and CD163 expression can be used as predicator for early relapse and as new therapeutic targets in cHL.

Renal cell carcinoma (RCC) is the most prevalent malignancy of kidney. Snail is a zinc-finger transcription factor, associated with advanced tumor stage and poor prognosis of RCC. Insulin-like mRNA-binding protein3 (IMP3) immunopositivity predicts metastatic progression and patients’ survival in RCC. Aldehyde dehydrogenase 1 (ALDH1) is a stem cell marker, expressed in many different solid tumors of bladder, pancreas, colon, and kidney. The present study aimed to assess the diagnostic value of Snail, IMP3, and ALDH1 expression in clear cell, papillary, and chromophobe variants of RCC.
This retrospective study included 50 tissue blocks of RCC cases (35 clear cells, along with 11 papillary and four chromphobe carcinomas). Immunohistochemical staining was evaluated using antibody against Snail, IMP3, and ALDH1 in all the cases.
Snail was observed to be 74.3% in clear cell RCC and 18.2% in papillary, but negatively expressed in all chromophobe carcinomas. IMP3 was expressed in 72.7% of papillary carcinomas and 28.6% of clear cell RCC; it was totally expressed in all chromophobe carcinomas. ALDH1 was expressed in 94.2% of clear cell RCC, 54.6% of papillary carcinomas, and 50% of chromophobe carcinomas. Snail, IMP3, and ALDH1 were found to be associated with advanced tumor stage and high grade; accordingly, they could be considered as poor markers for RCC patients.
ALDH1 is a good sensitive marker for diagnosis of RCC, especially for clear cell type, while IMP3 is a good marker for diagnosis of chromophobe carcinoma and Snail can be used for diagnosis of clear cell carcinoma.

The increasing incidence of hepatocellular carcinoma (HCC) is a challenging health problem worldwide with poor prognosis and limited treatment options. The association between metabolic factors and HCC has been documented, however, there is a shortage of data about this association in our locality. Therefore, we aimed to determine the pattern of lipid profile in cirrhotic patients with HCC and investigate the association between dyslipidemia and HCC. In this case-control hospital-based study, serum lipid profile [total cholesterol, triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very-low-density lipoprotein (VLDL)] was determined in 100 patients with cirrhosis and 100 patients with cirrhosis and HCC. Multivariate analysis of HCC risk factors was done. Metabolic syndrome, hypertriglyceridemia, hypercholesterolemia, high LDL, and combined dyslipidemia were significantly more frequent in HCC patients than non-HCC patients. Low HDL and dyslipidemia were significantly associated with the late HCC stages and LDL levels were significantly correlated with α- fetoprotein levels. There was a tendency towards increasing the values of the other lipid parameters in advanced stages. Metabolic syndrome and combined dyslipidemia were associated with HCC risk. Deranged lipid profiles were common in HCC patients. Metabolic syndrome and combined dyslipidemia could be potential risk factors for HCC and may offer a useful strategy for risk stratification; thus, their control can reduce the HCC burden.

Heavy metal (HM) toxicity has been described as a risk factor for the development of prostate disease in men and its assessment could predict susceptibility to prostate cancer (PCa). The current study aimed to assess the levels of HM (selenium [Se], copper [Cu], chromium [Cr] and lead [Pb], iron [Fe], zinc [Zn], magnesium [Mg], and cobalt [Co]) in men with PCa.
90 men aged 40 to 75 years, including 30 men with PCa, 30 with benign prostatic hyperplasia (BPH), and 30 controls, were recruited in this case-control study. Prostate specific antigen (PSA) was estimated via enzyme linked immunosorbent assay and heavy metals with atomic absorption spectrophotometry. Body mass index (BMI) was also determined.
The men with PCa had significantly higher BMI, PSA, Fe, and Pb and lower Mg, Zn, Cu, and Se compared with the controls. They also had higher PSA, Fe, and Co compared with the BPH (P < 0.05). Those with BPH had higher BMI, PSA, and Fe and lower Mg, Zn, Cu, Se, and Co compared with the controls (P < 0.05). Zn was positively correlated with Mg (r = 0.937, P < 0.001, Cu (r = 0.548, P = 0.002), Se (r = 0.731, P < 0.001), and Co (r=0.733, P < 0.001) only in the men with PCa. Levels of Cu, Mg, and Se were associated with the risk of BPH and PCa.
The men with prostate disease were found to have higher levels of lead and iron and lower magnesium, copper, selenium, and zinc, which necessitate assessment of these elements for early detection of prostate cancer and monitoring the progression of the disease.

Breast cancer is among the most prevalent cancers in women. Radiotherapy is an important part in treatment of breast cancer, associated with some side-effects, including skin dermatitis. Dermatitis may be severe and impair quality of life. Multiple agents have been studied, but no standard treatment is yet available. Silicone based gel (StrataXRT) was promising in some studies in reducing skin inflammation and also radiotherapy-induced dermatitis.
This was a randomized trial on 100 women with breast cancer who had undergone quadrantectomy for breast cancer. They received StrataXRT gel or best supportive care during radiotherapy. Dermatitis area and grade of dermatitis were measured.
Regarding the mean size of radiation-induced dermatitis area, there was a significant difference between the intervention (36.88 cm2 ± 69.93) and control (83.83 cm2 ± 79.34) groups (P = 0.002). During radiotherapy, except in the fourth week, dermatitis was significantly more severe in the control group.
It seems that StrataXRT is helpful in decreasing radiotherapy-induced dermatitis.

The present study was conducted to examine the possibility of detecting different types of lung lesions, such as cancer, using ultra-low dose (ULD) chest computed tomography (CT) images. In this basic (experimental) study with CT images, 20 patients with different lung disease indications were scanned with ULD and routine dose chest CT protocols. ULD and routine dose CT images were reconstructed utilizing iDose and iterative model reconstruction. CT images were evaluated by two expert radiologists. Volume CT dose index (CTDIvol), dose length product, and effective dose were used for dose assessment in both protocols. CTDIvol and dose length product for ULD protocol were 98% less compared to those for routine chest CT. The chest CT images for ULD and routine dose were diagnosed as normal in three patients with lung lesions, such as nodules, masses, plural effusion, fibrosis, diffuse ground glass opacities, bronchiectasis, and infiltration, in 17 patients. Patient dose of ULD chest CT (0.11mSv) is comparable to Poster-Anterior plus Lateral (0.1 mSv) chest radiograph, while the effective dose due to routine chest CT is about 5.1 mSv. Diagnostic findings regarding ULD chest CT images with 98% of dose reduction were compared to those for routine dose. We concluded that it may be utilized as a very useful tool for screening and the follow-up of different lung diseases, malignancy for instance. ULD chest CT with 98% of dose reduction could be a suitable substitute for chest radiograph, with higher diagnostic values.

Hypopharyngeal carcinoma (HPC) is a rare head and neck cancer which poses many therapeutic challenges. There is limited evidence regarding the outcomes of HPC treatment in Iran.
In this retrospective cohort study, we evaluated patients treated with chemoradiation or radiation alone, between 2007 and 2016 in the radiation oncology ward of the cancer institute affiliated to Tehran University of Medical Sciences. The design of the study was reviewed and approved by the local institutional review board (code: 86100142). All patients underwent definitive radiotherapy with or without concurrent or sequential chemotherapy. We assessed the two-year overall survival (OS) as the primary outcome. The progression-free survival (PFS) was our secondary outcome.
We studied 40 patients whose median age was 58 years. 37 patients were stage 3 or 4, while the most common stage was T3N1-2, observed in 35% of the cases. The most common site of involvement was pyriform sinus (47.5%). The twoyear OS rate was 29%. The two-year PFS was 22%. In the univariate analysis, N0-1 vs. N 2-3 and stage 2 vs. stage 3-4 were significant predictors of OS. In addition, distant metastasis had almost a significant association with lower OS.
The outcome of locally advanced HPC was not promising using 3DCRT alone. It is necessary to implement dramatic changes in the management of these patients to achieve better outcomes.

Seroma is the most prevalent complication after mastectomy and can lead to significant morbidity. No single method has been shown to be completely effective in reducing seroma rates. Flap fixation can reduce the dead space after mastectomy, thus decreasing the drainage volume and seroma rates. Gentamicin acts against Staphylococcus epidermidis involved in increasing drainage volume, duration, and seroma rates. This study aimed to evaluate the effect of combining flap fixation with gentamicin lavage of the surgical bed for reducing postmastectomy seroma. This prospective randomized controlled study included 100 women with breast cancer scheduled for modified radical mastectomy (MRM). The patients were allocated into the following four groups of 25: GI: flap fixation; GII: surgical bed lavage with gentamicin-containing solution; GIII: both techniques used in GI and GII; GIV: control group. The patients were followed up for the registration of drainage volume, timing of drain removal, and incidence of seroma. Total drainage volume was significantly lower; the drain was removed earlier and seroma rates were lower in group III than the other groups (P = 0.001, 0.009, and 0.005, respectively). Seroma in GIII was mild and managed with aspiration. In the other groups, seroma was more severe and required more aspirations, second tube drainage, or open drainage. Combining flap fixation and gentamicin lavage of the surgical bed after MRM significantly decreased the amount of drained fluid, allowing an earlier removal of the drain and decreasing the incidence of seroma when compared with using each procedure alone. Moreover, the severity of seroma was significantly lower when both techniques were combined.

To date, no studies have investigated the anticancer potential of Fagonia arabica. we aimed to investigate the antitumor potentiality and radiosensitizing effect of Fagonia arabica ethanolic extract (FAEE) on mice bearing solid ehrlich carcinoma (EC). This experimental animal study included 80 Balb-c mice and divided them into four groups: Group I: 10 EC-bearing mice as untreated controls; Group II: 10 EC-bearing mice exposed to a single dose of ionizing radiation (IR) at tumor localization (6Gy); Group III: 30 EC-bearing mice, each 10 mice received different dose of FAEE (250, 500, and 1000 mg/kg/day); Group IV: 30 EC-bearing mice, each 10 mice received different dose of FAEE (250, 500, and 1000 mg/kg/day) plus a single dose of IR (6Gy). P-FOXO3a and p-AKT levels were measured in tumor tissue homogenate via ELISA technique. BCL-2 gene expression was assessed with realtime polymerase chain reaction. Tumor tissues were stained with haematoxylin and eosin stain and examined. FAEE has antiproliferative effect on EC-bearing mice reflected by the decrease in tumor volume and tumor growth rate in a dose-dependent manner. Combination of FAEE with IR significantly increased radiation-induced tumor damage in comparison with IR alone. We observed a significant decrease in the concentration of p-AKT and p-FOXO3a and down-regulation of BCL-2 gene in the EC-bearing mice treated with FAEE only or in combination with IR. FAEE may be an effective antitumor agent against breast cancer. FAEE exerts radio-sensitizing effect, especially at a dose of 500 mg/kg. FAEE interferes with the apoptosis process via decreasing p-AKT and p-FOXO3a and down-regulation of BCL-2 gene.

Testes being in close proximity to radiation fields in patients of rectal cancer treated with radiotherapy, inadvertently receive a part of the radiation dose. This study was conducted to evaluate the variation of male sex hormones during the course of radiotherapy in patients with rectal cancer.
In this single-institution prospective study, 20 patients with carcinoma rectum were included. The patients were treated with 3-dimensional conformal radiation therapy or intensity modulated radiation therapy technique to a dose of 50.4 Gy for five weeks. Serum testosterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH) levels were obtained prior to and in the meantime of radiotherapy. The post treatment hormone levels were compared to the baseline values. The mean, percentage, standard deviation, and paired t-test were used for statistical analysis.
The mean dose received by the testes was 2.65 Gy (1.96 Gy to 4.96 Gy), which accounted for 5.25% of the total dose. The baseline values of serum testosterone, FSH, and LH were 4.65 ± 0.7 ng/ml, 7.57 ± 1.2 mIU/ml, and 7.93 ± 1.1 mIU/ml, respectively. There was a 32.1% drop in the post treatment testosterone levels compared with the baseline. There was a 77% rise in the post treatment FSH and 40.2% rise in the post treatment LH levels compared with the baseline. There was a significant difference in the rise of LH levels in the patients who received a testicular dose more than 2Gy compared with those who received a dose less than 2 Gy.
Radiation therapy was found to have a significant acute impact on male sex hormones in patients receiving radiotherapy for rectal cancer.

Due to the complexity of prognosis, diagnosis, and treatment in the process of providing care for patients with oral cancer, a large amount of data elements have been processed. The present study was conducted to provide a minimum data set for managing the data generated in the diagnosis and treatment processes of oral cancer by reviewing the specialized literature, medical records and by gathering expert opinions.
This research was a descriptive cross-sectional study with the following steps: reviewing texts and records, developing a draft of data elements, organizing a panel of experts, Delphi techniques, and creating a final pattern.
The framework proposed in this study for managing the data generated in the diagnosis and treatment processes of oral cancer was divided into six sections: management data with four-axis, historical data with four-axis, paraclinical indicators with two-axis, clinical indicators, data related to the therapeutic measures, and mortality data.
The systematic collection of the data associated with the diagnosis and treatment of the patients with oral cancer could provide a good basis for identifying patients or those who are susceptible to this type of cancer in the community. These data can also be used in programs to prevent the development and/or emergence of the disease, thus the health of the community.

Public awareness and attitudes toward cancer and cancer patients are highly important in enhancing the effectiveness of cancer screening and early diagnosis programmes. This study aimed to explore the public attitudes toward cancer and cancer patients in Jordan.
A cross-sectional design was used to conduct this online survey study in Jordan between March 20th and April 20th 2020.The sample was conveniently selected, and 1157 participants were included from the public. The Public Attitudes toward Cancer Questionnaire was employed.
Descriptive statistics, unpaired t-test, ANOVA, and multiple linear regression were utilized. The mean age was 44.2 years (SD = 20.1), and 53% were female. The total mean attitude score was 38.2 (SD = 4.3). Based on the results, having a family member or a friend with cancer (P = 0.003), willingness to be informed about cancer diagnosis (P = 0.001), informing a friend about cancer diagnosis (P = 0.021), and willingness to participate in screening and early detection programmes (P < 0.001) were significant predictive positive attitudes towards cancer and cancer patients. In addition, being married predicted more negative attitudes compared with being single (P = 0.001).
This study demonstrated that Jordanians had positive attitudes toward cancer and cancer patients and most were willing to be informed about cancer diagnosis. This calls for healthcare providers to adopt shared decision models when devising health care plans for cancer patients, with more involvement on the parts of both patients and family members rather than adopting a paternal approach. Policy makers and managers should consider positive attitudes when developing healthcare programmes to enhance public participation in early cancer detection and screening programmes so a s to reduce cancer mortality and morbidity rates.

Understanding the prevalence, clinical characteristics, and changing demographics of Indian bladder cancer (BC) has emerged as an important field of study. Herein, we aimed to present the case series of BC patients of a single tertiary care centre in North Karnataka. This retrospective study was designed for 14 years from 2004 to 2017, conducted in the urology clinic. A total of 468 newly diagnosed BC patients (male = 415; female = 53) were included in the study. Sociodemographic, clinical characteristics, cystoscopic, and pathological findings were recorded and analyzed via IBM SPSS statistics software Inc. version 20.0. The mean age of the patients was male = 62.27 years and female = 54.22 years. Hematuria was a common clinical symptom in both genders accounting for 42.02 versus 45.28% of the male and female subjects, respectively. Transition cell carcinoma (TCC) was the common variant seen in the male and female participants (92.99 versus 94.88%, respectively). Low-grade cancer was found in patients with >60 years of age in 39.7% versus 42.1% of respectively the males and females (P = 0.002) as compared to the patients <60 years. Non-muscle invasive BC in the males and females was respectively 55.42% versus 52.83%, whereas muscle-invasive cancer was 44.57% versus 47.16% respectively in the two groups (P = 0.008). 53 patients (29.22%) in the both genders received transurethral resection/intravesical Bacilli Calmette-Guerin therapy, which showed a significant improvement (P = 0.019).
Transition cell carcinoma was found to remain the predominant type of BC with painless hematuria in North Karnataka population. This has seriously affected the public health; this trend is expected to be continued due to the high prevalence of smoking. There should be further emphasis on primary prevention of BC by conducting smoking cessation awareness programs.

Primary mediastinal germ cell tumors accounts for about 3%-15% of the mediastinal malignancies. Nonseminomatous tumors make a small percentage of germ cell tumors. Treatment of mediastinal choriocarcinoma includes initial systemic chemotherapy, followed by complete resection of all residual tumors. However, patients with nonseminomatous tumors have very poor prognosis.

Cystic hygroma (CH) is a congenital malformation of the lymphatic system commonly treated with surgical excision. The typical locations of this lesion are the cervico-facial and cervicothoracic region and other rare locations include axilla, mediastinum, and limbs. CH usually presents at birth as a painless mass, which concerns parents. It might also be detected as complications resulting from it, such as respiratory distress fever, a sudden increase in the size, feeding difficulty, and infection. To the best of our knowledge, there are a few cases reported in cervico-axillo- thoracic variants and we reported giant cervico-axillo-thoracic cystic hygroma, which is thoroughly treated with surgical excision. A 45-days female, full-term delivery, infant presented with big right-side trunk mass, diagnosed through computed tomography scan as a CH involving the right lateral and posterior chest wall with extension to the axilla and right side of the neck, which was managed with surgical excision. After a 6-month of follow-up, no recurrent lesion masses were detected. CH is a congenital malformation of the lymphatic system that can be treated in the pediatric population. The treatment option depends on size, age, and location of the lesion. In our case, complete surgical excision was the selective treatment for this lesion.