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   2013| October-December  | Volume 2 | Issue 4  
    Online since November 20, 2013

 
 
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ORIGINAL ARTICLES
Papillary thyroid carcinoma, a diagnostic approach in fine needle aspiration: Review of literature
Shirish S Chandanwale, Harsh Kumar, Archana C Buch, Shruti S Vimal, Pinky Soraisham
October-December 2013, 2(4):339-343
DOI:10.4103/2278-0513.121536  
Background: Despite well-defined cytology features of papillary thyroid carcinoma (PTC) in fine needle aspiration (FNA), diagnostic difficulties do exist while making decision in respect to papillary thyroid carcinoma (PTC) cases. Aims: The aim of this study is to clarify diagnostic significance of various cytology features of PTC and to identify possible diagnostic pitfalls. Materials and Methods: FNA cytology (FNAC) features and clinical findings of 17 PTC cases diagnosed on histology were retrieved. A retrospective review of these cases was performed. Results: The frequency and number of papillary formations, intranuclear cytoplasmic inclusions (INCI), and nuclear grooves (NG) was more in PTC cases as compared to suggestive/suspicious of (S/O) and rule out (R/O) PTC cases. Cyst macrophages forming clusters were seen in six cases. Multinucleated giant cells (MGC) were seen in seven cases. Large MGC with dense cytoplasm and more nuclei were seen in four PTC and one S/O PTC cases. Conclusion: FNAC features of PTC in FNA smears are neither constant nor specific. All the cytology features of PTC should be reported in proper context which allows endocrine specialist to treat and urgent histological verification.
  5,147 114 -
Diagnoses of breast masses with ultrasonography and elastography: A comparative study
Md. Sohaib Akhtar, Tariq Mansoor, Rabeya Basari, Ibne Ahmad
October-December 2013, 2(4):311-318
DOI:10.4103/2278-0513.121525  
Context : Non-invasive diagnoses of breast masses remain a challenge to the clinician. Elastography, a new modality using elastic property of breast tissue can effectively differentiate between malignant and benign breast masses minimizing the need for aggressive unnecessary biopsy. Aim: The aim is to evaluate elastography to ascertain whether the differentiation and characterization of benign and malignant breast lumps could be done with it, comparing with the conventional sonography. Settings and Design : Single institutional prospective study. Materials and Methods: The study was conducted on 82 patients with palpable breast lumps. All these cases were subjected to a thorough clinical examination, sonography, elastography, and pathological diagnosis. Results of sonography and elastography were compared considering the pathological diagnosis as standard. Statistical Analysis : Statistical analysis was performed with the McNemar test. All data analysis was conducted using SPSS software (SPSS Inc.). Results: It was observed that the USG diagnosis of carcinoma tallied with the pathological diagnosis in only 88.9% of cases (i.e. 48 out of 54 cases) and the elastographic diagnosis of carcinoma tallied with the pathological diagnosis in 96.3% (i.e. 52 out of 54). On the other hand, out of 34 and 30 cases diagnosed as benign lesions on USG and elastography, respectively, only 28 cases were proved to be benign pathologically. Conclusion: Elastography was found to be more sensitive, specific, and accurate than sonography.
  4,293 128 2
Immune hyperplasia patterns in lymph nodes draining breast cancer: A correlation with histomorphological parameters
Sheena Khetarpal, SK Mathur, Divya Sethi, Rajeev Sen
October-December 2013, 2(4):330-338
DOI:10.4103/2278-0513.121532  
Background: Lymph nodes serve as site of immunologic expansion of lymphocyte populations. Enlargement of nodes may be caused by spread and growth of cancer cells or it can be due to reactive hyperplasia of lymph nodes. Aim : To study the pattern of reaction in involved and uninvolved lymph nodes draining breast carcinoma and correlate different patterns of hyperplasia with other morphological parameters in modified radical mastectomy (MRM) specimens. Material and Methods: Histopathological examination of 734 lymph nodes isolated from MRM specimens over a period of 2 years was performed on routine microsections. Results: Mixed pattern of hyperplasia was the most widespread followed by the diffuse pattern, the follicular hyperplasia, sinus histiocytosis, and paracortical hyperplasia in decreasing order. Follicular hyperplasia was seen in 23.44% of the ductal carcinomas and 36.36% of the malignant phylloides tumor. Sinus histiocytosis was seen in 23.53% of the metaplastic carcinomas, 22.22% of the medullary carcinomas with a decline to 12.10% amongst the ductal carcinomas. However, mixed pattern of hyperplasia was seen in 28.57% of the papillary carcinomas, 26.31% of the lobular and 27.41% of the ductal carcinomas. The incidence of sinus histiocytosis increased from 10.96 to 23.68% with the grade of tumor. There was a decline in the incidence of sinus histiocytosis, paracortical hyperplasia with the increase in the size of the tumor. Conclusions: The assessment of the reactive behavior of lymph nodes serves as an indicator to the histologic immunostaging of malignant tumors. This data indicate that the lymph node reaction to cancer and their incidence and prognostic significance may vary depending upon the stage and type of tumor.
  4,052 77 -
Detection of bone marrow metastases in prostate cancer: Role of trephine biopsy and Immunohistochemistry
Manish Kumar Singh, Madhu Mati Goel, US Singh, Diwakar Dalela, SN Shankhwar, Ashutosh Kumar
October-December 2013, 2(4):319-324
DOI:10.4103/2278-0513.121526  
Context: Bone marrow (BM) metastases are an integral part of tumor dissemination in many malignancies. Prostate carcinoma, which has high tendency to metastasize to bone, shown to have affinity for endosteal niche as well as tendency to compete with hematopoietic cells to home in BM. This marrow dissemination can be confidently proved by histopathological examination of BM. Aims: In this study, we are trying to detect the presence of metastases and micrometastases in BM of prostate carcinoma patients with the help of immunohistochemical markers prostate-specific antigen (PSA) and prostate-specific acid phosphatase and correlate the findings with American Joint Committee on Cancer Tumor, Node and Metastasis 7 th (2010) classification, serum PSA, and biopsy Gleason's score. Materials and Methods: We performed BM examination and hematological workup of 11 known prostate carcinoma patients including metastatic cases also, during our study period of 1 year. The BM biopsy sections and clot sections were used to carry out immunohistochemistry. The data were analyzed by using SPSS (Statistical Package for Social Sciences) version 15.0 statistical analysis software. Results: We found that two patients were positive for metastases in BM out of the 11. Both of these patients already had metastases to other site with very high serum PSA levels. Anemia was common hematological alteration in both of them and one of them showed increased osteoblasts in the aspirate film. Conclusion: Taking into account our small sample size and short study duration, we conclude that further large sized future studies with long-term follow-up in to this BM dissemination by prostate cancer cells could open new horizons to understand the biology of metastasis of this common malignancy and also provide more effective therapeutic options as well as prognostic implications in these patients.
  4,000 109 -
CASE REPORTS
Peritoneal lymphomatosis mimicking peritoneal carcinomatosis - a clinical dilemma: Series of two cases and review of literature
Manisha Jana, SH Chandrashekhara, Tamojit Chaudhuri, Pramod K Julka, Dodul Mondal
October-December 2013, 2(4):356-358
DOI:10.4103/2278-0513.121547  
Peritoneal lymphomatosis is a rare presentation of non-Hodgkin lymphoma and most often associated with abdominal organ involvement. The diagnosis is often difficult and needs to be differentiated from peritoneal carcinomatosis and tubercular peritonitis. Imaging, though helpful in disease staging, may not lead to a specific diagnosis; which rests on the histopathological findings. We present two cases of peritoneal lymphomatosis with different presentations and extranodal sites of involvement.
  3,692 100 -
REVIEW ARTICLES
Role of neoadjuvant chemotherapy in cancer cervix: A brief review
Aramita Saha, Anindya Mukherjee
October-December 2013, 2(4):281-286
DOI:10.4103/2278-0513.121515  
Neoadjuvant chemotherapy (NACT) represents a promising modality apart from or radiotherapy as initial treatment of locally advanced cervical cancer. The primary objectives of NACT in the treatment of cervical cancer include improvement in tumor characteristics, to allow avoidance of radiotherapy, to prolong disease-free and overall survival, and facilitation of fertility-sparing surgery. Though several studies have shown promising results of NACT on tumor response, downstaging, decrease in local recurrence, improved progression free survival, yet its role is controversial and plenty of study results are waiting to establish its efficacy. After reviewing the available literatures in the internet, and focusing the light of our continuous 3 years experience, we have made an effort to find out the relevance of NACT in cancer cervix. NACT is feasible and produces impressive responses in cervical carcinoma, as has been demonstrated by several phase II and phase III trials. Some meta-analysis suggested that NACT followed by surgery improves overall survival compared with nonstandard radiotherapy alone.
  3,436 203 2
CASE REPORTS
A rare case of minimal deviation mucinous adenocarcinoma of the uterine cervix and review of literature
Rashmi Kushwaha, Yogesh Kumar Yadav
October-December 2013, 2(4):362-364
DOI:10.4103/2278-0513.121549  
Minimal deviation adenocarcinoma (MDA) is uncommon and accounts for only 1-3% of all cervical adenocarcinomas, and most pathologists diagnose only one or two cases during their professional life. MDA is unusually well-differentiated adenocarcinoma of the cervix formed by neoplastic cells displaying only minimal cytological atypia. Because of the high degree of differentiation, there is a high frequency of failure to diagnose this malignancy histologically. To better understand the presentation of MDA, we are reviewing the clinical, histological, and immunohistochemistry findings in one case.
  2,312 67 -
ORIGINAL ARTICLES
Baseline characteristics predictive of malignancy among patients presenting with lymphadenopathy: A cancer center experience
Huifang Lu, Xerxes Pundole, Shana Palla, Khanh Vu
October-December 2013, 2(4):325-329
DOI:10.4103/2278-0513.121531  
Context: Patients who present to tertiary cancer centers solely with radiologic evidence of lymphadenopathy often are diagnosed with malignancy, but it is unclear which baseline characteristics are predictive of a cancer diagnosis. Materials and Methods: We conducted a retrospective data review to determine baseline characteristics predictive of a cancer diagnosis and the optimal follow-up time for such patients. Results: Sixty-six adult patients with lymphadenopathy were evaluated. Thirty-six patients (55%) were diagnosed with cancer; the most common type was lymphoma. Cancer was diagnosed in 94%, 79%, and 70% of patients with supraclavicular, retroperitoneal, and abdominal lymphadenopathy, respectively. Increasing age and hypertension were associated with a cancer diagnosis in the multivariate analysis. The mean time to diagnosis was 15 days (range, 1-140 days). The average follow-up time was 18 months in patients without a cancer diagnosis. Conclusions: Patients presenting solely with lymphadenopathy at a cancer center have a higher likelihood of being diagnosed with cancer if they are at least 50 years old or have hypertension. Supraclavicular lymphadenopathy is highly associated with a malignant diagnosis. We suggest that patients presenting solely with lymphadenopathy should be followed-up for at least 6 months for a definitive diagnosis.
  2,294 83 1
CASE REPORTS
Squamous cell carcinoma kidney in a 29-year-old male: A case report with review of literature
Animesh Saha, Chhaya Roy, Sajal Kumar Ghosh
October-December 2013, 2(4):347-349
DOI:10.4103/2278-0513.121543  
Primary malignant tumors of the renal pelvis are relatively rare with squamous cell carcinoma (SCC) accounting for 0.7-7%. Few cases of primary SCC of kidney have been reported in the world literature. The insidious onset of symptom and lack of any pathognomonic sign, leads to delay in the diagnosis and subsequent treatment, resulting in grave prognosis for these patients. We present a case of 29-year-old male with hydronephrosis of the left kidney with renal pelvis mass where histology of resected specimen shows SCC.
  2,218 78 1
REVIEW ARTICLES
Histamine revisited: Role in acute myeloid leukemia
Prasan R Bhandari
October-December 2013, 2(4):287-293
DOI:10.4103/2278-0513.121516  
Histamine dihydrochloride (HDC) is derived from biogenic amine histamine. It suppresses the production of reactive oxygen species which inhibits the stimulation of T cells and natural killer (NK) cells. Co-administration of the cytokine interleukin (IL)-2 and HDC assists the activation of T cells and NK cells by IL-2, causing in the destruction of cancer cells, including those of acute myeloid leukemia (AML). A significantly longer leukemia-free survival (LFS; primary endpoint) was demonstrated in a phase III trial in adult patients with AML in first or subsequent remission, in those who received subcutaneous HDC and concomitant subcutaneous IL-2 as maintenance therapy compared to that of patients receiving no treatment. However, the difference in overall survival (OS) between the two groups was not significant. Patients had acceptable levels of adverse effects. Thus, HDC in addition to IL-2 appears to be a useful maintenance therapy option for adult patients with AML in remission.
  1,951 95 -
The role of Trastuzumab Emtansine as a novel-targeted therapy for HER2+ breast cancer: A systematic review
Nikki Bajaj, Hamid Shaaban, Gunwant Guron, Michael Maroules
October-December 2013, 2(4):275-280
DOI:10.4103/2278-0513.121514  
Trastuzumab is the first humanized monoclonal antibody targeted against the human epidermal growth factor receptor 2 (HER2), tyrosine kinase receptor, that has displayed excellent clinical activity in HER2-overexpressing breast cancer. Despite this, the majority of patients with metastatic HER2-positive breast cancer who initially demonstrate good clinical responses to trastuzumab within the first year of initiation of treatment start to develop resistance within 1 year of initiation of treatment. Even patients on trastuzumab-based chemotherapy regimens have been shown to progress within 1 year of therapy. The antibody-drug conjugate trastuzumab-DM1 (T-DM1) was designed to combine the biological activity of trastuzumab with the targeted delivery of a highly potent antimicrotubule agent, DM1 (N-methyl-N-[3-mercapto-1-oxopropyl]-l-alanine ester of maytansinol), a maytansine derivative, to HER2-positive breast cancer cells. Phase I and II clinical trials of T-DM1 as a single agent and in combination with paclitaxel, docetaxel, and pertuzumab have shown clinical activity and a favorable safety profile in HER2-positive metastatic breast cancer patients. The EMILIA study, a randomized phase III trial, has shown that T-DM1 provided objective tumor responses and significantly improved progression free survival and overall survival compared to lapatinib and capecitabine combination in HER2-positive metastatic breast cancer patients treated with a prior taxane and trastuzumab regimen. Based on these results, T-DM1 has been indicated in the management of patients with advanced and early stage HER2-positive breast cancer. In this review, we summarize evidence from clinical studies and aim to discuss the potential clinical and therapeutic implications of T-DM1 therapy in the management of HER2-positive breast cancer.
  1,751 168 -
Bisphosphonates and innovative drugs in the prevention of skeletal complications secondary to metastatic prostate cancer
Nabil Ismaili, Ali Tahri, Rhizlane Belbaraka
October-December 2013, 2(4):294-297
DOI:10.4103/2278-0513.121517  
Over than 80% of patients with locally advanced prostate cancer will develop bone metastases during the disease management. These metastases are often responsible for complications that impaired the quality of life, impaired the prognosis and increased the mortality by prostate cancer (PC). Two drugs are currently approved by the scientific community in the prevention of skeletal complications secondary to castration-resistant prostate cancer metastatic to bone (CRPCMB), zoledronic acid at a dose of 4 mg intravenously every 3-4 weeks and denosumab at a dose of 120 mg subcutaneously every 4 weeks. This aim of the preset paper was to review the current literature on the mechanism of action, efficacy, and safety profile of these two classes of molecules in the management of CRPCMB.
  1,753 85 1
ORIGINAL ARTICLES
Mitomycin C: An effective adjuvant in the management of ocular surface squamous neoplasia
Shashikala Puttaswamy, B Mala, G Nagaraju, D Raviprakash, KH Prakash
October-December 2013, 2(4):298-301
DOI:10.4103/2278-0513.121518  
Background: Ocular surface squamous neoplasia (OSSN) forms a spectrum of dysplasia from conjunctival-corneal intraepithelial neoplasia to an invasive squamous cell carcinoma (SCC). Management of OSSN is surgical excision; however, with a high reported recurrence rates (33 to 56%). Hence, Mitomycin C, a tumor-targeted deoxyribonucleic acid (DNA) synthesis inhibitor is considered as an adjuvant following excision of primary OSSN. Aim: To report the cure and recurrence rate with excision of primary OSSN with Mitomycin C as an adjunctive ina single ocular center over 1 year period. Materials and Methods: Twelve eyes of 12 patients with histologically proven primary were included in the study between 1 st Jan 2009 and 31 st Dec. 2009. Protocol for the management comprised of surgical excision of the lesion with a 3 mm of healthy rim with cryotherapy followed by topical Mitomycin C 0.04% four times a day to all postoperative patients in 3-4 cycles of alternate on and off weekly courses. At each visit, looked for recurrence of tumor and corneal alterations like keratitis or erosions. Efficacy of Mitomycin C as an adjuvant therapy was measured in terms of clinical cure and recurrence of the tumor. Results: Average age 45.25 years with 42% below 40 years with 83% male preponderance. With a follow up period of 44.5 months, 91.7% success rate found despite late stage presentation in our study. Conclusion: Hence, we conclude that, Mitomycin C treatment following surgical excision decreases the recurrencerate of primary ocular surface neoplasia and should be considered as adjunctive therapy in primary treatment.
  1,750 80 -
CASE REPORTS
A rare case of angiomyxoma vulva
Sabuhi Qureshi, Uma Singh, Nisha Singh, Mohd. Parvez Khan, Sakshi Agrawal
October-December 2013, 2(4):374-375
DOI:10.4103/2278-0513.121554  
Aggressive angiomyxoma is a rare, locally aggressive soft-tissue tumor that has a high propensity for local recurrence. It involves mainly the pelvis, vulva, perineum, vagina and urinary bladder in adult women in the reproductive age. Considering its locally aggressive nature, appropriate management and long-term follow-up is necessary. Though rare, this tumor needs to be considered in the differential diagnosis of vulval tumor. We describe a case of angiomyxoma in a 32-year-old young patient presenting with a large recurrent swelling of the left labia majora.
  1,649 73 -
Ewing's sarcoma humerus presenting along with metastatic breast nodule: An unusual case report
Sunita Singh, Shilpa Garg, Monika Sangwan, Jyoti Sharma, Rajeev Goyal
October-December 2013, 2(4):368-370
DOI:10.4103/2278-0513.121552  
Ewing's sarcoma is a highly malignant primary bone tumor and most frequently observed in children and adolescents but rare in adults. Usual sites of metastasis are lung, pleura, other bones and occasionally to lymph node, central nervous system, and liver. Metastasis into breast is extremely rare and only one case has been reported. Most common tumors metastasizing into breast are lymphoma, malignant melanoma, and rhabdomyosarcoma. A 25-year-old female presented simultaneously with both left arm swelling and breast lump. Fine needle aspiration done from both swellings revealed similar morphology and comprised monomorphic population of round cells dispersed singly with scant cytoplasm and reticulogranular chromatin. IHC done on cell block material was positive for CD99. Hence diagnosis of Ewing's sarcoma metastasizing to breast was made. Hereby, we present a rare case of Ewing's sarcoma humerus with simultaneous metastatic deposit in breast as the initial presentation.
  1,386 75 1
Primary rhabdomyosarcoma of the fallopian tube: A very rare case
Aramita Saha, Subrata Chattopadhyay, Partha Saha, Mohammad Azam
October-December 2013, 2(4):350-352
DOI:10.4103/2278-0513.121545  
Sarcomas of the fallopian tube are extremely rare malignancies, primary rhabdomyosarcoma (RMS) of the fallopian tube being exceedingly rare entity. We present here a case of primary RMS of the fallopian tube in a 72-year-old female who presented with occasional intermittent colicky abdominal pain and watery per vaginal discharge for 1.5 months. Macroscopic examination of the operated specimen of uterus and ovaries showed that the ampullary end of the right fallopian tube had a 9 cm tumor in its greatest axis. Microscopic examination revealed pleomorphic sarcoma of the right fallopian tube. Immunohistochemical examination revealed the tumor cells expressed desmin, myogenin, and smooth muscle actin (SMA); and are immunonegative for cytokeratin, epithelial membrane antigen (EMA), human melanoma black (HMB)-45, S-100 protein, and h-caldesmon; which was in favor of pleomorphic sarcoma, RMS. Considering the age, performance status of the patient and histology (RMS), adjuvant chemotherapy with single agent doxorubicin was considered.
  1,316 70 2
Metachronous presentation of breast sarcoma following carcinoma: A rare occurrence
Bhawna Bhutoria Jain, Chandan Roy Choudhury, Tshering D Bhutia, Madhumita Mondal
October-December 2013, 2(4):359-361
DOI:10.4103/2278-0513.121548  
Occurrence of bilateral breast neoplasms with same or different histology is rare. It can occur as synchronous (diagnosed within 3 months) or metachronous (separate occurrences) lesions. Breast sarcomas are the most unusual of all breast malignancies. Here, we have reported a case of a 50-year-old postmenopausal lady with metachronous presentation of breast neoplasms of different histology. Right breast ductal carcinoma (stage 3c), followed by left breast sarcoma (size 45 × 34 cm) diagnosed at an interval of 6 years. Modified radical mastectomy was done for both breasts, followed by adjuvant therapy.
  1,305 69 1
ORIGINAL ARTICLES
No evidence of correlation between p53 codon 72 polymorphism and risk of bladder cancer in Moroccan patients
Noma Berrada, Saad Amzazi, Rabii Ameziane-El-Hassani, Lala Benbacer, Mohammed Abbar, Abderrahmane Al-Bouzidi, Meriem Khyatti, Mohammed El-Mzibri, Ahmed Ameur, Mohammed Attaleb
October-December 2013, 2(4):302-306
DOI:10.4103/2278-0513.121521  
Background: The p53 codon 72 polymorphism has been investigated extensively for its association with various cancers around the world. Several studies have investigated the association between p53 polymorphism at codon 72 and risk of developing bladder cancer, but the results are still controversial. Aim: The aim of our study was to evaluate the association between the p53 polymorphism and the bladder cancer risk among Moroccan patients. Materials and Methods: This study was carried out on fresh biopsies from 41 patients with bladder cancer confirmed and 38 blood samples from control donors. Deoxyribonucleic acid was genotyped by "Allele-specific polymerase chain reaction" using specific primers to each polymorphic variant. Results: Frequencies of Arg/Arg, Arg/Pro and Pro/Pro genotypes among cases were 17%, 66%, and 17%, while in controls the frequencies of Arg/Arg, Arg/Pro and Pro/Pro were 15.8%, 63.2%, and 21%, respectively. The difference between cases and controls was not statistically significant. An increased risk of bladder cancer development was not clearly related to any polymorphic variant of the p53 Arg72Pro in our study group from Moroccan population. Moreover, the frequency of the Arg allele was higher (71.45%) than the Pro allele (28.55%) in high stage of bladder tumors, but this difference was statistically not significant. Conclusion: This study suggests that Arg allele could be more involved in developing bladder tumor in Moroccan population than the Pro allele. Therefore, enlarging the sampling will be necessary to confirm this association in Moroccan population.
  1,282 80 -
CASE REPORTS
Primary renal synovial sarcoma: Report of a rare case
Milind A Bhatkule, Manjusha S Dhawle, Hemant R Kokandakar, Rajan S Bindu
October-December 2013, 2(4):353-355
DOI:10.4103/2278-0513.121546  
Primary renal synovial sarcoma is a relatively recently described uncommon tumor of kidney, with only 34 cases described till date. We report a case of PRSS in a 19-year-old female who presented with a lump in right lumber region, along with brief review of literature.
  1,257 64 -
ORIGINAL ARTICLES
Prevalence based epigrammatic study of oral cancer and other mucosal disorders in elderly patients visiting dental institution of Northern India
Basavaraj T Bhagawati, Manish Gupta, Sharanamma Bhagawati, Avanti Aggarwal, Sachin Mittal
October-December 2013, 2(4):307-310
DOI:10.4103/2278-0513.121524  
Objective : This report provides the descriptive information about the oral health among the elderly population. The objective is to assess the association of age, medical status, recent use of dental services, habits and dentures with that of oral cancer, and other mucosal disorders. Materials and Methods: Data from the interviews and clinical examination of 285 persons aged above 60 years were obtained. Patients were divided into three groups of 75 patients each with age group of 60-65 years, 66-70 years, and 71 years above, respectively. Patients were examined and questioned regarding the oral health complaints and the presence of cancer and other mucosal disorders. Results: There are no statistically significant differentiates between the three groups in terms of oral health complaint, medical status. The patients in all the three groups gave the history of consumption of betel quid/alcohol/smoking. About 22.1% patients in Group A, 18.9% in Group B, and 37.9% in Group C had associated mucosal lesion like oral cancer, growth, pigmentation, red lesion, ulcer, and white lesions. Association between deleterious habits and oral mucosal lesions was seen in 12, 15, and 16 patients in Groups A, B, and C, respectively. Conclusion: The oral cancer and oral mucosal lesions were associated with oral habits and the use of faulty dentures. Age had minimal influence but coexistence of multiple conditions might further complicate the oral health.
  1,213 107 -
CASE REPORTS
Long term survival of locally advanced carcinoma larynx in an 8-year-old child
BK Viveka, Anil N Kumar, L Appaji, Ashok M Shenoy
October-December 2013, 2(4):344-346
DOI:10.4103/2278-0513.121538  
Paediatric laryngeal squamous cell carcinomas (SCC) are described in a very small percentage of children. These tumors are presented in the advanced stage because of lack of clinical suspicion. The treatment of paediatric laryngeal SCC is not well-defined. We report a successfully treated locally advanced glottic SCC in an 8-year-old child.
  1,188 64 -
Bilateral adrenocortical carcinoma presenting as acute adrenal insufficiency with co-existing active pulmonary tuberculosis: A diagnostic dilemma
Bitoti Chattopadhyay, Biswamit Bhattacharya, Atri Chatterjee, Nirod Baran Debnath
October-December 2013, 2(4):371-373
DOI:10.4103/2278-0513.121553  
We report a case of a 58-year-old male patient presenting in a state of drowsiness with recurrent hiccups who was found to have hypotension and hyponatremia. He was found to have bilateral adrenal masses with peripheral rim enhancement and central necrotic destruction on contrast enhanced computerized tomography scan of abdomen which accounted for the presentation of acute adrenal insufficiency. Histopathological examination of the adrenal mass was reported as bilateral adrenocortical carcinoma. He also revealed evidences of sputum-positive active pulmonary tuberculosis in absence of any lung mass. Bilateral adrenal mass is an extremely rare condition in its own right and co-existence of such pathological condition with tuberculosis both of which can predispose to acute adrenal crisis, is even rarer. This report emphasizes the need for histopathological diagnosis in every patient of adrenal mass as presumptions can potentially lead to fatal errors.
  1,184 60 -
Primary renal lymphoma in patient of tinea incognito: Rare clinical entity
Ritam Joarder, Debangshu Bhanja Choudhury, Arya Sen, Krishnangshu Bhanja Choudhury, Shyam Sharma
October-December 2013, 2(4):365-367
DOI:10.4103/2278-0513.121551  
A middle aged male patient, suffering from tinea incognito for 3 months along with history of significant weight loss for last 2 months, was admitted for hematuria in emergency ward. He was subsequently diagnosed with left renal mass. Computed tomography scan of abdomen showed a large lobulated density mass in lower pole of left kidney, over circling the left pelviureteric junction causing hydronephrosis and no hepatosplenomegaly. There was no evidence of retroperitoneal lymphadenopathy, peritoneal nodules, or ascites. Clinically suspecting renal cell carcinoma, the patient declined radical left-sided nephrectomy as the primary choice of treatment. Tru-cut renal biopsy revealed diffuse large Bcell non-Hodgkin's lymphoma. Following six cycles of chemotherapy along with antifungal medications, both tinea lesions and renal mass were cured.
  1,164 64 -
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