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   Table of Contents - Current issue
Coverpage
March-April 2017
Volume 6 | Issue 2
Page Nos. 123-147

Online since Monday, August 14, 2017

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ORIGINAL ARTICLES  

Quality of life assessment of oral cancer patients after mandibular resections using the University of Washington Quality of Life (Version 4) questionnaire: Reconstruction with pectoralis major myocutaneous flap p. 123
Drasty Vora, Jigna Shah, Bhargav Maharaja
DOI:10.4103/2278-0513.213013  
Objectives: Mandibular resection for oral cancer is a mainstay and prime requirement to achieve an acceptable boundary of tumor removal. Mandibular resection has been related with a poor health-related quality of life (HRQOL). The objective of this study was to evaluate the HRQOL in patients who have undergone mandibular resections of oral cancer and reconstructed with pectoralis major myocutaneous flap (PMMF). Patients and Methods: There were 192 consecutive patients between 2011 and 2014 who were treated for head and neck cancer; among them, 65 patients having oral cancer were treated with mandibular resections. HRQOL was assessed by the University of Washington QOL (UWQOL) questionnaire version 4 after 3–12 months postoperatively. Study Designs and Results: In the UWQOL, the best-scoring domains were shoulder, recreation, and pain, whereas the lowest scores were for speech, chewing, and swallowing. Conclusions: Mandible reconstruction with PMMF would have significant influence on patients' QOL and oral functions. The societal and literary data show a low level of education and low economic status for the majority of patients.
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Clinicopathological study of recently added glioneuronal tumors p. 128
Pritilata Rout, Ashish K Chand, BN Nandeesh, GD Veerendra, Manmeet Singh Chabra
DOI:10.4103/ccij.ccij_30_17  
Background: Glioneuronal tumors are pathologically heterogeneous group of tumors containing both glial and neural components or glial tumors with neural differentiation. In the year 2007, three new entities have been added to the repertoire of glioneuronal tumors by the World Health Organization (WHO) which include papillary glioneuronal tumor (PGNT) (WHO Grade I), rosette-forming glioneuronal tumor of the fourth ventricle (RGNT) (WHO Grade I), and glioneuronal tumor with neuropil-like islands (GTNIs) (WHO grade II/III). The present study summarizes the clinical and neuropathological features of these three glioneuronal neoplasms. Materials and Methods: This study included seven cases of newer glioneuronal tumors (four cases of PGNT, two cases of RGNT, and one case of GTNI) which were reviewed. Results: The clinical presentations (patient characters), radiology, squash preparations, histology, and immunohistochemical findings of these cases are discussed including some of the morphological variations and follow-up. Conclusion: Glioneuronal tumors show considerable morphological and clinical diversity with some unique features. As these neoplasms are low grade and well manageable, the knowledge of their clinical presentation and histological diagnosis is essential for treatment. The present study is an attempt toward this.
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CASE REPORTS Top

Unprecedented remission with radiotherapy alone: A rare case of mutilating scalp recurrence of Hodgkin's lymphoma with preexisting chronic liver disease p. 134
Koushik Chatterjee, Kiran Shankar Bhattacharya, Suman Ghorai, Anupam Datta
DOI:10.4103/ccij.ccij_25_17  
Recurrence of Hodgkin's lymphoma in the scalp is extremely rare (only one such case reported, way back in 1970) and its treatment in the setting of chronic liver disease is unknown. We hereby report the second case of recurrent Hodgkin's lymphoma of the scalp, in a 28-year-old male, presenting as a mutilating ulcer over the entire right hemicranium with autoamputation of the right pinna. He was unfit for chemotherapy in view of his preexisting chronic liver disease and was therefore treated with radiotherapy alone, to the dose of 40 Gy in 20 fractions over 4 weeks in conventional fractionation, using Tele-Cobalt 60, leading to complete and sustained remission (at 5 years follow up) and unprecedented organogenesis of the scalp and the pinna.
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Follicular dendritic cell sarcoma of the tonsil: A rare entity p. 137
Renu Sukumaran, Rekha A Nair, P Sindhu Nair
DOI:10.4103/ccij.ccij_27_17  
Follicular dendritic cells (FDC) are nonlymphoid, nonphagocytic accessory cells in the immune system. They have major roles in antigen presentation and regulation of germinal center reaction. FDC sarcoma is a rare and under-recognized malignancy. Most of the cases are reported in the lymph nodes. The typical morphology is syncytial aggregates of oval/spindly cells with vesicular bland nuclei and small nucleoli. Focal whorling and storiform pattern, multinucleate giant cells, and the presence of small lymphocytes in the background give additional clues for the diagnosis. As spindle cell tumors are rare in the lymph nodes, FDC sarcoma comes under the differential diagnosis of spindle cell neoplasms of the node and an accurate diagnosis is often rendered. However, when the neoplasm occurs in extranodal sites, the diagnosis is often missed because the FDC markers are not routinely used in the immunopanel for undifferentiated neoplasms. Because of its rarity, the extranodal FDC sarcomas pose a great diagnostic challenge and often misdiagnosed initially. Herein, we report a case of FDC sarcoma of the tonsil in a 36-year-old female patient. Biopsy of the lesion showed oval to spindly cells in syncytial sheets and focally in whorled pattern. The individual cells were having plump vesicular nuclei and small nucleoli. Occasional multinucleate cells and sprinkling of lymphocytes within the tumor were also noted. The tumor cells were positive for CD23 and CD35. A diagnosis of FDC sarcoma was given. Greater awareness of the morphologic spectrum of FDC sarcoma and appropriate immunostains for FDC differentiation will help in recognition of this rare neoplasm.
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Gastric outlet obstruction accompanied by a diffuse segmental pneumatosis cystoides intestinalis p. 141
Wassim Almahli, Latif Yilmaz, Alper Aytekin
DOI:10.4103/ccij.ccij_35_17  
Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple thin-walled, gas-filled cysts in the submucosal or subserosal layer of the gastrointestinal wall. PCI is not well understood. Symptoms associated with it are nonspecific, commonly including abdominal pain and distension, diarrhea, bloody stool, and constipation. In this report, we present an interesting case of gastric outlet obstruction associated with PCI in an elderly male patient, who was successfully treated by the gastroenterostomy.
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A case of a male with sigmoid adenocarcinoma which accompanied with an isolated unilateral adrenal metastasis p. 144
Wassim Almahli, Ilyas Baskonus, Alper Aytekin, Latif Yilmaz
DOI:10.4103/ccij.ccij_36_17  
Although the liver and the lung are the main metastatic sites, the incidence of adrenal metastasis from colorectal cancer in autopsy ranges from 1.9% to 17.4% according to different reports. The most common primary tumors that metastasize to the adrenal glands are the lung, kidney, breast, and rarely colorectal cancer. The alone adrenal metastasis due to colorectal carcinoma is very rare. Due to their rarity, on the basis of international literature and our experience of adrenalectomy could represent the current “gold-standard” therapeutic approach. In this report, we explain the case of a patient who presented with sigmoid cancer and one side adrenal metastasis without any other different distant metastases.
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