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   Table of Contents - Current issue
May-June 2018
Volume 7 | Issue 3
Page Nos. 87-126

Online since Thursday, December 6, 2018

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Epidemiology of female reproductive cancers in Mazandaran Province (Northern Iran): Results of the Mazandaran population-based cancer registry Highly accessed article p. 87
Akbar Hedayatizadeh-Omran, Reza Alizadeh-Navaei, Majid Yaghoubi Ashrafi, Zainab Ghazizadeh, Rasieh Sadat Mousavi, Ramin Shekarriz, Mohammad Eslami Jouybari, Ehsan Zaboli, Ghasem Janbabaei, Siavash Moradi, Mohsen Aarabi, Mahmood Moosazadeh, Parisa Eslami
Purpose: Cancer is a most important disease, and female reproductive system cancers are the most common cause of women mortality rate. Materials and Methods: This cross-sectional study analyzed medical record data for 4460 patients in Mazandaran population-based cancer registry. Results: The mean (standard deviation) age of these patients was 53.45 years, and the incidence rate of female reproductive cancers (age-standardized incidence rate) was 8.51 per 100,000 persons-year. These cancers incidences were more in urban than rural, but this difference was not significant. Differences between frequency of uterus and ovary cancers with tumor behavior are significant (P = 0.046). Conclusion: This certainly calls for further attention to preventive and treatment planning on female reproductive system cancers.
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Long-term management of temporomandibular joint degenerative changes and osteoarthritis: An attempt p. 90
G Venkata Surya Sudhakar, M Sai Laxmi, T Rahman, D S L Anand
Background: Osteoarthritis is the inflammation of body joints characterized by chronic degeneration of various hard and soft tissues around joint. Stress-bearing joints of body such as knee, hips, spine, fingers, and temporomandibular joint (TMJ) are commonly affected. Aims and Objectives: The aims were (1) to study whether constant masticatory mechanical overloading causes osteoarthritis and degenerative changes of TMJ in patients who underwent segmental mandibulectomy with primary repair (without microvascular free flap reconstruction) for malignancies of the mandible, floor of the mouth, and lower gingivobuccal sulcus; (2) to evaluate the effect of nutrition supplements such as glucosamine, chondroitin, and esterified fatty acids in reducing TMJ osteoarthritis and internal derangement; and (3) to assess whether joint flexibility and function improved after using the above medication. Materials and Methods: Patients with osteoarthritis and internal derangement of TMJ as well as patients who underwent segmental mandibulectomy followed by postoperative radiotherapy were randomly selected and included in the study. Age group of the patients ranged between 20 and 76 years. Results: One hundred and ninety-two patients of segmental mandibulectomy were screened and 79 patients were found to develop osteoarthritis in the longer contralateral mandibular segment (41.14%). This finding was statistically significant in our study (P < 0.05). Thirty-six patients of primary TMJ osteoarthritis and internal derangement were also included in the study. The efficacy of oral regimen with glucosamine with chondroitin and esterified (acetylated) fatty acids was found to be effective and satisfactory in controlling the progression of osteoarthritis and degenerative changes in TMJ in patients of both categories. Conclusion: Osteoarthritis of TMJ is a degenerative disorder. Age and masticatory load are one of the main contributing factors for its progression. TMJ internal derangement in chronic condition can lead to osteoarthritis. Conservative methods to control its progression will improve joint flexibility and longevity of joint function. Oral regimen of glucosamine with chondroitin and esterified fatty acids has shown satisfactory results in treating TMJ osteoarthritis and internal derangement.
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BRCA 1 and 2 mutations in carcinoma breast: An Indian study p. 97
Anvesh Rathore, Subhash Ranjan, S Vishwanath, Abhishek Pathak, AP Dubey, P Nikhil
Background: Breast cancer is the most common cancer affecting women all over the world. In India, it is the second most common solid-organ malignancy after carcinoma cervix. Worldwide, approximately 5%–10% of the cases have been associated with various germline mutations. However, in India, studies correlating germline BRCA mutation with various clinicopathological variables are rare. In this study, we have tried to find out the difference in BRCA-mutated and BRCA-nonmutated patients. Materials and Methods: From May 2015 to May 2017, 50 patients with carcinoma breast were subjected to BRCA mutational studies by next-generation sequencing and further subdivided into BRCA-mutated and BRCA-nonmutated subgroups. Their clinical, pathological, characteristics were recorded and compared between two subgroups. They were followed up for a minimum of 9 months, and response to treatment was also recorded. Results: Out of 50 patients with carcinoma of the breast, only six patients were detected to be mutated and pathological mutations were detected in two (4%) patients only. All the BRCA-positive patients were female only. The most common age of presentation was >50 years while BRCA-positive patients presented earlier. Triple-negative breast cancer (TNBC) was the most common presentation and most patients presented in Stage III. Conclusion: Germline mutations in carcinoma breast can account for around 5%–10% of total breast cancers all over the world, but in our study, we have reported that 4% of the patients had BRCA mutations. BRCA-mutated carcinoma breast presents at younger age and more frequently with bilateral presentation as compared to BRCA-negative disease. BRCA-mutated carcinoma breast presents with more advanced disease and usually has a significant family history of either first- or second-degree relatives being affected. Overall TNBC status was more commonly found in both subsets of the patients. Overall BRCA-positive disease had more aggressive course of the illness as compared to BRCA-negative patients.
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Evaluation and comparison of conventional brush-based and centrifugation liquid-based cytopathology p. 104
Abhishek Banerjee, Venkatesh Vishwanath Kamath
Background: Brush cytopathology is a traditional method of collecting shed cells by scrapping off the mucosal surface of the oral cavity. Liquid-based cytopathology by centrifugation is a technique that causes the cells to be suspended in a monolayer enabling better morphological assessment. Aims: The aim of this study is to compare the efficacy of conventional brush cytopathology and centrifugation-based liquid cytology (CBLC) in oral lesions after staining with rapid Papanicolaou (PAP) stain. Materials and Methods: Forty cases of oral lesions comprising normal mucosa (n = 10), hyperkeratotic lesions (n = 11), ulcerated lesions (n = 15), and inflammatory lesions (n = 14) were selected. Two smears were obtained from the lesion using a cytological brush. One was spread on the slide using conventional technique, fixed immediately in 95% ethyl alcohol. The second sample was suspended in prepared fixative solution for 10 min and then spun in centrifuge for 10 min. The supernatant was poured off, and the obtained cell pellet was used to prepare a smear by sedimentation and left to dry overnight. Both the smears were stained by rapid PAP (Biolabs Pvt. Ltd.). The stained smears were compared statistically for cellular yield, cell distribution, cell morphology, and background noise (presence of blood, inflammatory cells, microbial colonies, and artifacts). Results and Conclusion: The efficacy and quality of the smears based on the liquid-based preparations indicated its superiority in obtaining a higher yield of cells and clearer background. The increased cellular yield in liquid-based preparations also showed increased clumping and overlapping of cells which proved as a drawback for CBLC.
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A case of myelodysplastic syndrome with bone marrow fibrosis and isochromosomy of 17(q10) p. 110
Nasim Valizadeh, Marjan Yaghmaie
Isolated isochromosome (17q) is reported in patients with myelodysplastic syndrome (MDS)/myeloproliferative disorders. It is a poor prognostic marker. We report clinicopathologic feature of a 26-year-old male a civil engineer with MDS and secondary fibrosis and isochromosomy of 17(q10). He had a history of working in gold mine and an accessory testis in a physical examination.
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Teratocarcinoma of maxillary antrum: A rare presentation of extragonadal germ cell tumor p. 113
Kakali Choudhury, Partha Dasgupta, Bodhisatta Roy, Nishana Paul
Germ cell tumour (GCT) is a neoplasm derived from germ cells. Extra gonadal GCTs (EGGCT) are that which origin outside the gonads as a result of errors during development of embryo. The Mediastinum is the most common anatomic site for EGGCTs in adults. Maxillary GCTs are very rare and commonly occurs within the first three decades of life. Seminomatous EGGCTs variety have better prognosis than non seminomatous variety when treated with combined modality therapy (CMT). A 21 years male patient presented with left sided facial swelling of 3 months duration along with proptosis, nasal intonation of voice and difficulty in opening the mouth. On examination, a single diffuse swelling noted on the left side of the face. CECT showed left sinonasal mass extending to nasopharynx, infratemporal fossa, left orbit and also to subcutaneous plane. He was managed by left sided maxillectomy followed by adjuvant chemotherapy and radiotherapy. EGGCT mostly occours in mediastinum followed by abdomen, mostly sacrococcygeal region. EGGCTs are most common in paediatric age group (two third of GCT is extragonadal), adults and adolescents mostly suffer from gonadal GCT. In this era of combined modality management surgery combined with chemotherapy and radiotherapy gives the best outcome.
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Primary pulmonary spindle cell carcinoma in a young nonsmoker patient p. 116
Amitesh Gupta, Parul Mrigpuri
Spindle cell carcinoma (SCC) is a very rare type of tumor. Very few case reports of primary pulmonary SCC have been reported in the literature. It is a type of sarcomatoid carcinoma with very poor prognosis. It is usually seen in patients in the age group of 50–80 years. Exact etiology is unknown till now. We report a rare case of primary pulmonary SCC in a young nonsmoker patient who presented in a very advanced stage.
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Cytokeratin positivity in secondary angiosarcoma of breast: A diagnostic pitfall p. 119
Prakriti Gupta, Seema Rao, Sunita Bhalla
Reappearing breast lump in a known case of breast carcinoma often turns out to be a recurrence of the carcinoma. However, in patients receiving radiotherapy for the disease, possibility of secondary angiosarcoma should also be suspected. Secondary angiosarcoma can pose a challenge in pathological diagnosis especially in small trucut biopsies. Aberrant expression of epithelial marker can also add to the difficulty. In this article, we report a case wherein similar difficulties were faced during the diagnosis.
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A rare case report of central neurocytoma p. 122
Rituparna Biswas, KP Haresh, Subhash Gupta, Anirban Halder, GK Rath
Central neurocytoma (CN) is a slow-growing, benign brain neoplasm with a favorable prognosis and, using clinical and imaging findings, one can significantly limit the differential diagnosis. They develop preponderantly in young adults, most often in the lateral ventricles. This report describes a case of CN in a 19-year-old patient, the signs and symptoms, imaging, histopathology including immunohistochemistry, and the treatment applied.
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Heart rate variability in male breast cancer p. 125
Reema Shyamsunder Shukla, Yogender Aggarwal
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