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  Citation statistics : Table of Contents
   2016| November-December  | Volume 5 | Issue 6  
    Online since February 14, 2017

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Ancient schwannoma of neck masquedring as sarcoma
Tummidi Santosh, Sulata Choudhury, Prasanta Kumar Das, Manoj Kumar Patro
November-December 2016, 5(6):537-539
Ancient schwannomas are rare benign encapsulated tumors of long standing duration. These tumors are usually solitary and may grow to a large size before detection of notable degenerative changes. The term “ancient schwannoma” is used to describe a schwannoma that has undergone changes such as relative loss of Antoni Type A tissue, perivascular hyalinization, calcification, cystic necrosis, hemorrhage and the presence of degenerative nuclear changes that may be misinterpreted as sarcomatous change. We report a case of ancient schwannoma in the left side neck.
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Pre-B acute lymphoblastic leukemia masquerading as breast carcinoma: A rare case report
Rahul S Kulkarni, Asha S Anand, Sonia K Parikh, Priyanka Patel
November-December 2016, 5(6):544-547
Leukemic involvement of the breast is very rare and more commonly seen in acute myeloid leukemia. Involvement of the breast in acute lymphoblastic leukemia (ALL) at diagnosis is very rarely reported and is often confused with primary breast tumors. We present a case of young female presenting with breast mass and axillary lymphadenopathy, thus masquerading as breast carcinoma. Breast biopsy and bone marrow examination revealed leukemic infiltration of pre-B cell ALL. Cerebrospinal fluid showed involvement with leukemic cells. The patient was treated with MCP-841 protocol and therapeutic cranial irradiation, followed by maintenance oral chemotherapy leading to complete resolution of breast mass. Thus, ALL should be considered in the list of differential diagnosis of breast masses, especially in young females.
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Colonic lipoma: A rare yet important cause of intestinal obstruction
Savita Agarwal, Pinki Pandey, Shruti Singh, Megha Ralli
November-December 2016, 5(6):548-550
Gastrointestinal tract (GIT) lipomas are rare, benign mesenchymal neoplasm affecting all segments of the GIT and colon is affected most frequently. Reported incidence of colonic lipomas varies from 0.2% to 4.4%. These tumors are believed to arise from the connective tissue of the wall of the intestine. We here describe a case of 60-year-old male who presented with features of intestinal obstruction. The patient underwent left hemicolectomy for a mass involving proximal descending colon. Diagnosis of colonic lipoma was made on histopathological examination.
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Incidence of tobacco chewing in families of patients with oral squamous cell carcinoma
Rashmi Nigudkar, Minal Chaudhary, Madhuri Gawande, Swati Patil, Alka Hande, Lalit Kanthale
November-December 2016, 5(6):513-515
Introduction: Oral cancer is a major health problem worldwide, owed to its high incidence and low survival rate as well as to the functional and cosmetic deficiencies that accompany the disease even after the treatment. The occurrence of oral cancer is particularly high among men, for whom it is the eighth most common cancer. Aim and Objectives: (1) To evaluate the effectiveness of antitobacco campaign. (2) To assess the prevalence of deleterious habits among families of patients with oral squamous cell carcinoma (OSCC). Materials and Methods: The study was carried out in the Department of Oral Pathology and Microbiology and 30 histopathologically diagnosed cases of OSCC were included in the study. The family members of these patients were given a questionnaire. Results: It was found that out of the 30 families included, only 7 families were such, in which the patient as well as the family members had quit the habit. Only 2 families were such that only the patient had the deleterious habit. Conclusion: Tobacco smoking and chewing is one of the prime factors responsible for oral pre-cancer and cancer. The incidence and prevalence of such lesions in South Asian countries like India is high owing to the increased production and consumption of tobacco.
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Clear cell adenocarcinoma of uterine cervix in a 19-year-old virgin unrelated to diethylstilbestrol exposure
Purnima Thakur, Vikas Fotedar, Mukesh Sharma, Kavita Mardi
November-December 2016, 5(6):527-529
Clear-cell carcinoma of cervix (CCC) is rarely seen in clinical practice nowadays, especially post the diethylstilbestrol (DES) era. Its association is well established with DES exposure in the adolescent age group. We report a rare case of CCC in a 19-year-old Asian female with no history of exposure to DES. She underwent radical hysterectomy with unilateral salpingoopherectomy and was kept on follow-up and had shown no signs of recurrence even after 1 year of follow-up. Relevant literature is reviewed including possible etiology, appropriate treatment, and prognostic factors.
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Primary extraskeletal peripheral primitive neuroectodermal tumor of subcutaneous tissue neck in a young adult: A rare case report
Sumeet Aggarwal, Vivek Kaushal, Abhishek Soni, Sujata Singla
November-December 2016, 5(6):530-532
Primitive neuroectodermal tumors (PNETs) are poorly differentiated small round cell neoplasms which primarily affect childhood age and very rarely seen in adults. Peripheral PNET (pPNET) cases are very rare compared to central PNET, and most of them originate from neural crest cells located outside the central nervous system. We report a case of large extraosseous pPNET arising from subcutaneous tissue of left side neck in a young male patient. Despite aggressive inherent nature of histology, structural complexity of neck area and poor predictors like tumor size >6 cm, extraosseous nature, this case advocate that complete resolution is possible with aggressive multimodal treatment including surgery, radiation therapy, and chemotherapy. Other major concerns in such cases of pPNET are difficulty in diagnosis due to low incidence, unpredictable site involvement, histological similarity with other round cell tumors and lack of established treatment guidelines.
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Synchronous multifocal osteosarcoma with small cell histological variant: A double rarity
Sonia Gon, Tamalika Kundu, Bidisha Naskar Ghosh
November-December 2016, 5(6):533-536
Multifocal osteosarcoma (MFOS), osteosarcoma involving multiple sites, is a rare variant of osteosarcoma. When the lesions appear within 6 months of initial presentation of the tumor, it is known as synchronous MFOS. Synchronous MFOS has an incidence of 1%–3% only. Moreover, the histological variant of small cell osteosarcoma is even rarer. A case of 14-year-old male with synchronous MFOS of small cell type involving frontal and mandibular bone simultaneously is being reported here. It poses a dilemma to both the clinician and the pathologist to diagnose whether it represents multiple primary tumor or metastatic disease.
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Primary intracranial malignant melanoma in an adolescent girl: A case report
Sajeeb Mondal, Rajashree Pradhan, Subrata Pal, Supratik Bhattacharya, Arindam Banerjee, Debosmita Bhattacharyya
November-December 2016, 5(6):551-553
Primary intracranial malignant melanoma is a very rare tumor, and most of the central nervous system melanomas are metastatic diseases. Diagnosis needs extensive dermatological, opthalmological, and radiological workup to exclude metastatic melanoma. Histologically, it should be differentiate from benign melanocytic lesions, pigmented choroid plexus carcinoma, and pigmented papillary medulloblastoma. Here, we are reporting a case of primary malignant melanoma of posterior fossa in an adolescent girl diagnosed in squash cytology as well as in histology and confirmed by immunohistochemistry and by excluding metastatic melanoma.
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Primary small cell carcinoma of kidney in a young female: A rare case report
Ajay Kumar Pal, Sudheer Rathi, Krishna Murty, Nishant Misra
November-December 2016, 5(6):540-543
Small cell carcinomas (SCCs) occur mainly in pulmonary tract while extrapulmonary SCCs (EPSCCs) are rare neoplasms comprising approximately 2.5% of all SCCs. A 23-year-old female presented with complaints of hematuria and a mass in right flank region. She had no other complaints. Examination of the patient revealed lump in the right lumbar region with no other remarkable findings. Contrast-enhanced computed tomography showed a large heterogeneously enhancing necrotic mass involving the right entire kidney. A right radical nephrectomy was performed, and a histological examination revealed mass involving whole right kidney with capsular and lymphatic invasion along with small cell histology. The patient was given adjuvant chemotherapy of etoposide and carboplatin, every 3 weeks. The patient started complaining of bony pain after 1 month of operation, and bone scanning revealed of multiple osteoblastic lesions. Zoledronic acid (4 mg) had been started for bony metastasis. SCC of the kidney is a rare neoplasm of the elderly age group that has aggressive behavior with an increased tendency for locoregional and distant dissemination. Our patient represents the first case of SCC of the kidney to be reported in a young female.
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Accurate tumor size determination in breast cancer: The debate continues
S Navin Noushad
November-December 2016, 5(6):554-555
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Bone marrow involvement in Hodgkin's lymphoma: Data from a cancer hospital
Kriti Chauhan, Monica Jain, Pragya Shukla, Rajesh Kumar Grover
November-December 2016, 5(6):516-520
Objective: Bone marrow examination is essential for staging Hodgkin's Lymphoma (HL) at the time of diagnosis to determine the correct treatment and prognosis of the disease. The aim of this study was to analyze clinical presentation, hematological profile, biochemical profile, radiological presentation and patterns of bone marrow involvement in patients with Hodgkins lymphoma retrospectively. Materials and Methods: Bone marrow procedures were done in 49 cases of Hodgkins lymphoma a part of staging procedure. Results: 9 patients showed involvement of bone marrow by Hodgkins lymphoma. Clinically, 1 patient was staged as stage II (CSII), 2 patients as stage III (CSIII) and the remaining 6 as stage IV (CSIV) on the basis of extra nodal evidence of disease in liver, bone, lung or pleura on PET scan. The pattern of bone marrow infiltration was diffuse in 3 patients and focal in 6 patients. Length of the biopsy varied from 0.5 cm to 3.0 cm. Conclusion: BME should not be performed in all patients diagnosed with HL as a routine staging procedure. In an already known CS IA, IIA the incidence is very low and in CSIV it provides no additional therapeutic or prognostic information. However, patients with stage IIB, IIIB, IIIA and with any of the following: leucopenia, elevated LDH or ALP levels, splenomegaly should undergo biopsy of adequate length as additional prognostic information may be obtained. If it is suspicious of involvement, serial sections and contralateral biopsies should be examined so that even a single atypical cell or focus is not missed.
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Male breast cancer: A 10-year experience of a tertiary care center in North India
Asifa Andleeb, Mohammad Maqbool Lone, Hakim Irfan Ahmad, Fir Afroz, Arshid Manzoor, Mohammad Ashraf Teli, Kaneez Fatima
November-December 2016, 5(6):521-526
Background: Male breast cancer (MBC) is a rare disease and accounts for ∼1% of all cancers in men. Poor level of awareness often results in late presentation and delayed diagnosis. An increased incidence is seen in recent years. However, Indian literature is scant and we hereby present our data analyzed from a tertiary care center in North India. Aim: This study was done to analyze the demographic data, tumor characteristics, and management of MBC in Indian subset of patients and compare it with the literature available. Study and Design: This was a retrospective study from a tertiary care center. Materials and Methods: Data were collected from review of records of all male patients of carcinoma breast over a period of 10 years, i.e., from January 2005 to December 2015, who followed at our Institute. Results: During the study period, 53 cases of MBC were encountered; with ages of patients ranged from 35 to 80 years and a mean age of 60 years. As risk factor; 17 (32%) patients had sedentary life, six (11.3%) patients were obese, and four (7.5%) patients had positive family history. Breast lump was most common presenting symptoms seen in 39 (73.6%) patients. Within each breast, tumor was localized most commonly in central region (43.3%), followed by upper outer quadrant (32%). Stage I, II, III, and IV disease were encountered in 7.5%, 28.2%, 52.7%, and 11.3% of patients, respectively. Follow-up ranged from 1 to 144 months, with a median of 24 months. Conclusion: Male breast carcinoma is a disease of elderly people. Most of the patients presented late and in advanced stage of disease. Bone is the most common site of metastases.
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A prospective study of response and toxicity of weekly concurrent chemo-radiation with cisplatin versus paclitaxel in patients with locally advanced carcinoma cervix
Pabitra Das, Anis Bandyopadhyay, Swapan Kumar Sikdar, Debabrata Mitra, Shyamal Kumar Sarkar
November-December 2016, 5(6):507-512
Context: Concomitant chemo-radiation (CRT) with weekly cisplatin is the “standard of care” for treatment of advanced cases of carcinoma cervix. Although this standard of care reduces the risk of disease recurrence by as much as 50%, efforts are on for further improvement in response rate and local control. Aims: The present trial was planned to compare the response and toxicity of CRT with weekly paclitaxel versus weekly cisplatin in locally advanced carcinoma cervix. Subjects and Methods: Biopsy proven cases of squamous cell carcinoma, stage IIB–IIIB were randomized into two Arms. In Arm A, patients received external beam radiotherapy (EBRT) dose of 50 Gy in 25 fractions over 5 weeks with weekly Cis-platinum 40 mg/m2, whereas in Arm B patients received same EBRT with weekly paclitaxel 35 mg/m2 for 5 weeks, followed by intracavitary brachytherapy of 7 Gy x3# in both the arms. The primary endpoint was response at 3 months of completion of treatment, and secondary endpoints were to compare toxicity and compliance. Results: Thirty-two patients of carcinoma cervix were randomized to concurrent ciplatin arm (Arm A) and thirty patients to the concurrent paclitaxel Arm (Arm B). Most of the patients in both Arms had stage III B disease. Five cycles of weekly concomitant chemotherapy were received by 83.3% in Arm A and 60% in Arm B. 56.25% of patients in Arm A and 46.7% of patients in Arm B completed treatment within 8 weeks. There were statistically significant more Grade 2 and 3 diarrhea Arm B as compared to Arm A (P = 0.003). There were no Grade 4 adverse events or deaths. Response assessed at 3 month follow up and showed complete response of 83.33% in Arm A and 73.33% in Arm B (P = 0.521). The 18 months progression free survival was 86.6% in the cisplatin Arm as compared to 78.3% in the paclitaxel arm (P = 0.13). Conclusion: Concurrent paclitaxel with external beam radiation in locally advanced carcinoma cervix produces response comparable to concurrent cisplatin.
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