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   2018| July-August  | Volume 7 | Issue 4  
    Online since December 24, 2018

 
 
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ORIGINAL ARTICLES
Profile of p53 expression in epithelial ovarian carcinomas: A multicenter study from South-East Nigeria
Chinedu Onwuka Ndukwe, Lasbrey Asomugha Azuoma, Igwebuike Victor Onyiaorah
July-August 2018, 7(4):143-148
DOI:10.4103/ccij.ccij_69_18  
Background: Therapeutic targeting of mutated protein 53 (p53) will require the knowledge of mutated p53 expression. Currently, there is paucity of data on the expression of p53 in epithelial ovarian cancer (EOC) in Nigeria. Objective: This study therefore aims to carry out an immunohistochemical study of histologically diagnosed EOCs in Nnewi, South-East Nigeria. Materials and Methods: Hematoxylin and eosin slides and paraffin blocks of all histologically diagnosed cases of epithelial ovarian carcinomas in the two histopathology laboratories in Nnewi, Anambra State, over a 7-year period, were retrieved from the archives. Archival paraffin blocks of histologically normal ovaries in these laboratories were also retrieved to serve as controls. Sections were made from the tissue blocks and stained with p53 immunostain. Results: Fifty EOC specimen and twenty histologically normal ovaries were enrolled in this study. While 58% of EOC showed p53 positivity, none of the histologically normal ovaries showed p53 positivity. p53 expression was more common in those above 50 years of age, yet no association was found between p53 expression and age of patient. However, there was a statistically significant association between p53 positivity and tumor grade (P < 0.01), histologic subtype (P = 0.009) and molecular subtype (P < 0.01), with p53 positivity being more common in high-grade EOC, serous tumors, and Type 2 EOC. Conclusion: Overall, these data support the dualistic model of ovarian carcinogenesis in Nigerian patients and therefore, recommend intensified research into p53-targeted therapy.
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Outcomes of bladder cancer undergoing radical cystectomy: A single-institution experience
Ranjan Kumar Dey, Md Dawood Khan, Imran Ahmed Khan, Ranjit Kumar Das
July-August 2018, 7(4):127-131
DOI:10.4103/ccij.ccij_68_18  
Objectives: The objective of the study is to evaluate the functional outcome and postoperative complications of patients with bladder cancer undergoing radical cystectomy. Methods: This was a prospective, single-center study conducted between January 2013 and October 2016. Patients of either sex, aged more than 18 years, diagnosed with bladder cancer and treated with radical cystectomy and urinary diversion were enrolled in this study. Demographic and clinical characteristics, therapy and functional outcome details, and details of complications were collected. Results: A total of 94 patients were enrolled in the study. Overall, the mean age was 53.11 years and 74 (78.72%) patients were male. Of the 94 patients, 61 patients underwent radical cystectomy with ileal conduit (IC) and 30 patients had orthotopic neobladder. The sigmoid diversion was done in two patients, and one patient had a continent diversion. Four patients succumbed to mortality. Two patients had a recurrence at the urethral margin in IC patients. The functional outcome was found to be better in the neobladder group compared to the IC group. Conclusion: This study provides extensive information on outcomes of bladder cancer undergoing radical cystectomy. Studer's neobladder had slightly improved outcomes than IC.
  770 6 -
Extranodal non-Hodgkin's lymphoma: A case series
Sushama Gurwale, Charusheela R Gore, Kunjal Mukesh Karia, Sourabh P Paranjape, Padmakar R Bardapurkar, Harsh Kumar, Archana C Buch
July-August 2018, 7(4):137-142
DOI:10.4103/ccij.ccij_61_18  
Introduction: Primary extranodal lymphoma (pENL), a type of Non-Hodgkin's lymphoma (NHL) are the group of malignant neoplasms that arise from tissues other than lymph nodes and alsofrom the sites devoid of normal lymphoid tissue. The incidence of extranodal lymphoma (ENL) has an increasing trend and it accounts for one-fourth of all NHL. Any anatomical site of the body can be source of origin for the ENL. The presence of distinct clinical features in many variants of pENL has varied etiology, some may be associated with microbial infection, immunodeficiency syndrome, auto-immune diseases etc. Case Report: We highlight case series of 13 patients presenting with pENL which we encountered in the span of three years. The diagnosis of these cases was made on histopathology and immunohistochemistry. Discussion: The term ENL encompasses a variety of morphological variants, molecular alterations, clinical presentations; thereby posing a diagnostic challenge. They require varied therapeutic approach due to organ specific problems. These cases are discussed in order to emphasize on the increased incidence of these primary extranodal lymphomas.
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CASE REPORTS
Invasive squamous cell carcinoma of the conjunctiva: Report of a case diagnosed by imprint cytology and histopathology
Sunita Bagdi, Jyoti Prakash Phukan, Anuradha Sinha, Tirthankar Chakraborty
July-August 2018, 7(4):162-164
DOI:10.4103/ccij.ccij_58_18  
Conjunctival squamous cell carcinomas (SCCs) are rare neoplasms affecting commonly aged male patients. Sun injury, viral infections, and immunocompromised states are known etiological factors. A 49-year-old male presented with a rapidly growing exophytic mass in the left eye for 3 months. Imprint cytology from the mass was suggestive of invasive SCC, and subsequent histopathology confirmed the diagnosis. We are presenting this rare case for its usual (rapidly growing and exophytic) presentation.
  681 5 -
ORIGINAL ARTICLES
Increased visceral adipose tissue in male patients with clear cell renal cell carcinoma
Federico Greco, Vincenzo Cirimele, Carlo Augusto Mallio, Bruno Beomonte Zobel, Rosario Francesco Grasso
July-August 2018, 7(4):132-136
DOI:10.4103/ccij.ccij_62_18  
Background: Excessive accumulation of adipose tissue, mainly visceral, can determine adipocyte- and adipose tissue-related disorder. Visceral adipocytes secrete mediators associated with carcinogenesis. Several studies have shown a correlation between blood levels of these mediators and clear cell renal cell carcinoma (ccRCC). Indeed, specific biomarkers, including adipokines, have been considered as a possible link between obesity and RCC. Objective: The objective of the study is to test the hypothesis that there is an increase of visceral adipose tissue (VAT) in male patients with ccRCC. Methods: In this retrospective study, two groups were included: A group of patients with ccRCC and a control group without a history of malignancies. Total adipose tissue (TAT) area, VAT area, and subcutaneous adipose tissue (SAT) area were measured in both groups. VAT/SAT ratio was subsequently calculated. Results: Statistically significant differences between the two groups were found in VAT area (P = 0.01) and VAT/SAT ratio (P < 0.05), while no significant difference was found in TAT area and SAT area. Conclusions: This study shows an increased VAT in male patients with ccRCC.
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CASE REPORTS
Paratesticular rhabdomyosarcoma – Spindle cell variant: Case report of a rare tumor
Akansha Choudhary, Aswin Chandran Veluthattil, Pooja Uttam Mate
July-August 2018, 7(4):158-161
DOI:10.4103/ccij.ccij_31_18  
Testicular and paratesticular rhabdomyosarcomas (RMSs) in children are uncommon tumors. Histologically though embryonal RMS is common, the spindle cell variant is considered rare. Paratesticular RMS presents in children and adolescents with a unilateral, painless scrotal swelling or mass above the testis. We report the case of a 15-year-old boy, with a left paratesticular mass who underwent high inguinal orchidectomy. Histopathological examination of the specimen demonstrated spindle cell RMS (SC-RMS). Because of its morphological resemblance to spindle cell neoplasms such as leiomyosarcomas and fibrosarcomas, SC-RMS may pose diagnostic difficulties for the pathologist. This problem can be overcome by a careful search for rhabdomyoblasts in sections and immunohistochemistry for myogenin. We are reporting this case as paratesticular RMS itself is uncommon, and the spindle cell variant of embryonal RMS is all the more rare. There are lacunae in our knowledge about their presentation, diagnosis, response to treatment, and cure.
  619 5 -
Proptosis: A rare sole presentation of metastatic disease
Kalpana Sharma, Praveen Panwar, Rakesh Kumar
July-August 2018, 7(4):155-157
DOI:10.4103/ccij.ccij_21_18  
Orbital metastasis is identified clinically in very few cases having metastatic disease. We report a case of 62-year-old female having breast cancer for 4 years with sudden proptosis. She was further investigated to have multiple metastases. As these patients have dismal prognosis, the treatment can only be palliative. This case report impresses upon the need of thorough systemic evaluation in a known patient of cancer with proptosis because it can be the sole presentation of potentially alarming multiple metastases.
  610 6 -
Retroperitoneal malignant peripheral nerve sheath tumor
Jamal Jafari Nodoushan, Mojtaba Babaei Zarch
July-August 2018, 7(4):149-151
DOI:10.4103/ccij.ccij_23_18  
Primary retroperitoneal neoplasms are a rare entity and account for 0.1%–0.2% of all malignancies. In addition, only 1% of malignant peripheral nerve sheath tumors (MPNSTs) occur in retroperitoneal region. Herein, we report a case of retroperitoneal peripheral nerve sheath tumor in a 50-year-old man who presented with right lower limb pain. On physical examination, an abdominal mass was palpable. Computed tomography of abdomen with contrast, showed a large, lobulated mass, in the right paravertebral region extending to the middle area of abdomen and pelvis. The patient underwent exploratory laparotomy and mass excision. Histopathological examination was consistent with “MPNSTs.” This case report emphasizes that, although rare, MPNSTs may arise from retroperitoneal region. They have varied clinical presentations, and combination of microscopic, radiological, and immunohistochemical analysis is needed for diagnosis of MPNSTs.
  551 5 -
LETTER TO THE EDITOR
Pilomatrixoma: Cytodiagnosis without a “Shadow” of doubt!
Mona Agnihotri, Kanchan Kothari, Leena Naik
July-August 2018, 7(4):165-166
DOI:10.4103/ccij.ccij_34_18  
  441 5 -
CASE REPORTS
Cardiac micrometastasis of maxillary squamous cell carcinoma: A rare postmortem finding
Anshu Gupta, Khushboo Dewan, Vijay Dhankar
July-August 2018, 7(4):152-154
DOI:10.4103/ccij.ccij_19_18  
Secondary cardiac tumors are rare with an incidence of 2.3%. Common tumors metastasizing to the heart are lung, esophagus, breast, stomach, pancreas, melanoma, and colon. Only few case reports of oral squamous cell carcinoma metastasizing to the heart have been reported. Herein, we are presenting a case of a 17-year-old deceased male previously diagnosed with maxillary squamous cell carcinoma, found having multiple micrometastatic foci to the heart and lung in histopathological examination of tissues received after conducting autopsy. The involvement was limited to the myocardium with a normal pericardium and endocardium, which is not common. The case details and relevant clinical discussion are described to highlight asymptomatic, grossly inappreciable, micrometastatic foci of oral squamous cell carcinoma to myocardium.
  422 5 -
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