Neuroendocrine tumors (NETs) encompass a heterogeneous group of tumors demonstrating varied clinical behavior. The field has recently witnessed several important developments stemming from improvements in the histopathological classification schemes, advanced imaging techniques, and a deeper understanding of the molecular mechanisms underlying tumor progression. These tumors have indolent clinical courses, with long survival rates even for the patients with metastatic disease. The mainstay of treatment is surgery. Somatostatin analogs play a key role in controlling the symptoms; however, they are seldom associated with tumor regression. Traditional cytotoxic chemotherapies have a very limited role in well differentiated NETs, but platinum based chemotherapy is highly effective in neuroendocrine carcinomas. Recently, the biological targeted agents have shown promise in patients with metastatic disease. Evolving modalities like peptide receptor targeted therapies and radioembolization have opened up new avenues in refractory and advanced disease.

Context: Fatigue is an important symptom of cancer as well as a major side-effect of chemotherapy and is one of the main causes of decrease in physical performance brought on by the disease and its treatment. Several researches have been conducted to study the effect of exercise on relieving cancer related fatigue (CRF). This study will look into the effectiveness of exercise in reducing fatigue in patients of cancer undergoing chemotherapy. Aims: The aim was to study effect of a standard exercise program on fatigue in cancer patients on chemotherapy. Settings and Design: This was a case-control study conducted in a rural hospital setting. Materials and Methods: The case group was given an exercise intervention for 15 days and the control group was not given any intervention. The fatigue scores of both groups were assessed with the help of a Fatigue Severity Scale questionnaire 3 times during this time and compared. Statistical Analysis Used : An independent samples t-test was done to compare fatigue scores. Results: Fatigue scores collected from case and control group on the 15 ^th day showed statistical significance (t = 3.40 and P = 0.002). Conclusions: The study suggested that exercise was an effective intervention is reducing CRF in cancer patients undergoing chemotherapy. Further research is required to establish the type and duration of exercise that can provide optimum relief and alleviate the effects produced by CRF.

Introduction: Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy and is a major cause of cancer morbidity and mortality worldwide. Oral submucous fibrosis (OSMF) is a potentially malignant condition and it affects approximately 0.5% (5 million) people of the population in the Indian subcontinent. The present study has been undertaken to evaluate the genetic predisposition and frequency of specific finger and palm-print patterns in OSCC and OSMF patients by dermatoglyphic analysis. Materials and Methods: Fingerprints of 400 individuals were recorded with the help of korex duplicating ink consisting of 100 normal individuals without habit of chewing or smoking tobacco or betel nut, 100 normal individuals with habit, 100 OSCC patients, and 100 OSMF patients. Result: We found that whorl type of fingerprint pattern was predominant in significantly higher number of individuals of OSCC and OSMF group than in control groups, whereas individuals of both the control groups showed loop as a predominant fingerprint pattern. This indicates that the predominance of whorl type of fingerprint pattern would serve as a candidate screening marker for susceptibility to oral squamous cell carcinoma and oral submucous fibrosis in general population with or without tobacco chewing habit.

Background: Acute myeloid leukemia (AML) blast variably express Human leucocytic antigen (HLA).We retrospectively analyzed immunophenotypic and clinical profile of 12 cases of HLA -DR negative AML and correlated with their morphological, cytogenetics and Molecular findings.There is a paucity of literature mentioning morphological, immunophenotypic and cytogenetics characteristics of HLA DR negative AML. Aim: This study was designed to study the morphological, flow cytometric, and cytogenetics characteristics of HLA DR negative AML/non acute Promyelocytic Leukaemia (APML) cases. Materials and Methods: Seventeen such cases were diagnosed over a period of 1 year and 8 months. Peripheral blood and bone marrow aspiration smears were stained by Wright giemsa and examined by three hematopathologist independently. Immunophenotyping was done using multicolour flow cytometry on BD FACS CANTO II using FACS DIVA software.Conventional Karyotyping was done using Wright giemsa staining (using IKAROS software) and florescent in situ hybridization (FISH) was done using dual color dual fusion probe from Vysis promyelocytic leukemia-retinoic acid receptor alpha (PML-RARA) fusion gene probe. Molecular analysis using reverse transcriptase-polymerase chain reaction (RT-PCR) was done using Thermal Cycler of Applied Biosystem and Gel-Doc by Biorad. Results : Of the 12 cases studied ten were classified as French-American-British (FAB) AML-M1. Two case as FAB AML-M2. Morphologically the cells resemble abnormal promyelocytes with bilobation, convoluted and folded nucleus, inconspicuous nucleoli and open chromatin (n = 11) and with blastic morphology, open chromatin, and inconspicuous nucleoli (n = 1).Karyotyping analysis shows normal karyotype (n = 10), del 9q-(n = 1), and t (5:9) (n = 1) respectively.FISH done using dual color dual fusion probe (n = 12) do not show PML-RARA fusion signal.RT-PCR (n = 12) revealed a negative result for PML - RARA fusion transcripts. Conclusion: HLA-DR negativity does not always imply a diagnosis of APML. A Cytogenetic (FISH/conventional karyotype) or molecular (RT-PCR) evidence of t (15:17) or PML-RARA fusion gene transcript is a must to stamp a case as APML. Morphology and Flow cytometric findings are only complementary to Cytogenetic/Molecular findings.

Background: Cancer progression is a complex process consisting of a series of distinct steps. Cysteine proteases, such as cathepsins (Cts), are important molecules that play a central role in cancer progression and metastasis. Previous studies on human and mouse models of pancreatic cancer showed that both Cts B and Cts S are highly expressed in malignant tissues and the infiltrating macrophages. The aim of this study was to investigate the expression pattern of Cts B and S in human breast cancer tissues. Materials and Methods: Twenty-three formalin-fixed paraffin-embedded sections of breast cancer were stained for Cts B, Cts S, and CD206 using immunohistochemistry. Results: Cytoplasmic staining of Cts B and S was observed in tumor cells, endothelial cells, and macrophages. Cts B was preferentially expressed in breast cancer tissues by the different cells types. The majority of tumor samples were Cts B-positive in tumor cells, endothelial cells and macrophages (91%, 87%, and 70%, respectively) in comparison to Cts S (39%, 48%, and 57%, respectively; P < 0.001, P < 0.001 and 0.002). Correlation studies indicated significant relationships between the vascular and macrophage expression of Cts B (P = 0.01) and of Cts S (P = 0.03). However, neither Cts B nor Cts S expression in tumor cells correlated with other cell types (P > 0.05). Only the expression of Cts B in vascular endothelial cells correlated significantly with the tumor grade (P = 0.03). Conclusion: Results suggest that Cts B expression is more prominent than Cts S in breast cancer. Correlation studies imply different mechanisms regulating Cts B/S expression in tumor cells and other stromal components.

Intraoral solitary lipomas are very rare. In spite of under reporting, lipomas outnumber any other benign or malignant soft-tissue tumors by a considerable margin and represent the most common soft-tissue tumor. Fibrolipoma is a rare histologic variant of classic lipoma. In this paper, we have reported a rare case of solitary fibrolipoma of the oral cavity of 20 years of duration, with atypical histopathological features. In histopathology of case Lochkern cells were noted, these are atypical for usual fibroliopmas. Many lipomas remain unrecorded or are brought to the attention of a physician only if they reach a large size or cause cosmetic problems or complications due to proximity to vital structures. To the best of our knowledge, it is the first case of such long presentation of 20 years.

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (NK/T) is relatively rare, associated with aggressive behavior and poor prognosis. Histopathological findings, immunohistochemical study, and Epstein-Barr virus-encoded ribonucleic acid in situ hybridization are essential for the diagnosis. There are a few case reports in the literature describing the cytological findings of these uncommon lymphomas. We herein describe cytological findings in two cases of extranodal NK/T-cell lymphoma, nasal type presenting as lacrimal gland and/or nasal masses. Fine-needle aspiration smears revealed small to medium-sized lymphoid cells showing irregular nuclear outline, moderate amounts of light basophilic cytoplasm containing fine azurophilic granules in most of the cells. Some of these atypical lymphoid cells showed tongue-like projections of cytoplasm from one or both sides of the cells. Histopathological examination revealed typical angoicentric, angiodestructive growth pattern of these lymphomas.

Non-Hodgkin's lymphoma (NHL) is the second most common acquired immunodeficiency syndrome (AIDS)-defining cancer. In this population, up to 70-80% of cases may present as extranodal location as the primary clinical manifestation of the neoplasm disease. Gastrointestinal tract is the most frequent location of AIDS-associated NHL. However, salivary gland involvement, including the parotid gland is a rare complication in human immunodeficiency virus (HIV)-patients. Here, we describe a patient seropositive for the HIV, who developed a primary NHL of the parotid gland histologically classified as a high-grade diffuse large B-cell lymphoma. Patient was treated with a combination of chemotherapy plus highly active antiretroviral therapy with a good clinical, virological and immunological response and a prolonged survival, more than 5 years, without evidence of neoplasm relapse.

Children are predominantly nasal breathers, therefore obstruction of the nasal passage presents early with difficulty in breathing; however, with advance in age they soon adapt to mouth breathing. Chronic upper airway obstruction may result in cardiovascular complications such as pulmonary hypertension, right ventricular heart failure, and also renal disease. Therefore, we report the case of an 11-year-old Nigerian boy who had upper airway obstruction complicated with sleep apnea, pulmonary hypertension and cor-pulmonale resulting from sino-nasal (nasopharyngeal) non-Hodgkin lymphoma which is rare in African children

Low-grade adenosquamous carcinoma (LGAS) is an uncommon form of invasive mammary carcinoma. Though, it is categorized as a variant of metaplastic carcinomas, which are highly aggressive tumors, this tumor is relatively indolent with a good prognosis. Even though, it shows infiltrative growth LGAS carcinoma exhibits bland cytological features and can be mistaken for benign and other low-grade lesions. Hence, it poses a diagnostic challenge on cytology, core needle biopsy and frozen sections. It has a risk of local recurrence after incomplete excision and has a low metastatic potential. Hence, distinction from the benign mimics is essential in order to plan a proper treatment of either wide excision or mastectomy. We report a case of LGAS carcinoma of breast in a 57-year-old female along with the review of literature and differential diagnosis to highlight the diagnostic challenge it poses.

Von Hippel-Lindau disease is an autosomal dominant trait that predisposes individuals to benign and malignant tumors. It is rare, with prevalence of around 1 in 36,000. This case reports systematic limitations in knowledge of cancer syndromes, and provides a resource for junior doctors, as well as offering an interesting look at complex diagnostics.

Chylothorax is a rare complication in patients of lung cancer developing usually after cardiothoracic surgery or radiotherapy to chest. Chylothorax as an initial presentation is a rare manifestation of lung cancer. We report a case of squamous cell carcinoma of lung diagnosed after patient with features of superior vena caval (SVC) syndrome was placed on intercostal drainage tube and frank milky white fluid appeared. SVC syndrome was managed with hypofractionated radiotherapy to the mediastinum. However, chylothorax resolved only after two cycles of chemotherapy. A review of available literature on this rare association is also discussed along with.

Granular cell tumors (GCTs) are uncommon mesenchymal tumors of Schwann cell origin with malignant potential. A 50-year-old female presented with the complaints of swelling in right thigh since 1 year, associated with pain for 4 months. After clinical examination, imaging and histopathological examination diagnosis of malignant granular cell tumor (M-GCT)-Grade 1 (WHO grading of soft tissue tumors), stage-pT _2b N _x M _x was made. On immunohistochemistry tumor cells were positive for S-100 and Ki-67 expression was increased (>10%), confirming the histopathological diagnosis. M-GCTs though rare, are associated with local recurrence and metastasis. A thorough histopathological examination, grading and immunohistochemistry analysis is crucial for differentiation from benign soft tissue tumors. Fanburg-Smith et al. grading may aid in differentiating benign, atypical, and malignant variants. This case is reported for its rarity and to stress upon the importance of diagnosing malignancy in GCTs.

Umbilical cutaneous nodule can be due to infection, skin ailments and tumors. It can be primary or secondary in origin. When it is secondary due to metastasis from visceral malignancy then it is named as Sister Mary Joseph nodule. It can be a presenting symptom and sign of hidden malignancy and thus poses a diagnostic dilemma for physician. Our case presented to us with ulcerated umbilical nodule and subsequent ultrasound revealed accompanied urinary bladder malignancy. Mostly, these nodules are adenocarcinoma but our was an unusual case of transitional cell carcinoma.

Sialoblastoma is a rare congenital tumor of salivary gland. Herein, we report a case in a 5-year-old child who presented with a painless swelling in parotid region since birth and also review the literature. Surgical excision of parotid gland was done. Further, histopathological and immunohistochemical examination was performed and a final diagnosis of sialoblastoma was made. Patient is on follow-up 6 monthly.

Mandibular metastasis from papillary carcinoma of the thyroid is extremely rare. We report here a case of metastatic swelling on the mandible due to papillary carcinoma of the thyroid. The patient presented with jaw swelling and the thyroid lesion was an incidental finding on clinical examination. Computed tomogram scan revealed the presence of a contrast enhanced lesion in the thyroid and lytic expansile lesion in the body of the mandible. The diagnosis of papillary thyroid carcinoma (PTC) with mandibular metastasis was made after cytological examination of both the lesions. The patient was treated with surgery followed by radioiodine ablation. In conclusion, metastatic tumor to the jaw from a PTC is an extremely rare phenomenon and in the differential diagnosis of a metastatic jaw swelling small primary tumors of the thyroid should be excluded.

Rhabdomyosarcoma (RMS) is a common childhood cancer, constituting more than 50% of all soft tissue sarcoma, but it is an uncommon neoplasm in adult. We reported a case of 45-year-old male patient presented with a huge swelling in his left thigh. Magnetic resonance imaging of thigh revealed soft tissue mass involving the deep muscular compartment. Core biopsy and immunohistochemistry confirmed it as an embryonal RMS. The tumor showed a complete response after three cycles of neoadjuvant chemotherapy (CT) and then was treated with three more cycle of CT followed by adjuvant radiotherapy. This case is being reported on account of its rarity at this age and nonsurgical treatment. Pertinent literature is being reviewed.

Cerebral astroblastoma is one of the rarest tumors of the central nervous system and its classification, histogenesis, diagnosis and therapeutic management are still being debated. We present a rare case of histopathologically and immunohistochemically diagnosed low grade astroblastoma treated with surgery and postoperative radiotherapy successfully; although the case was low grade. We have given radiation in view of residual disease and unreliability for regular follow-up.

Sebaceous carcinoma is a rare, highly malignant, and potentially lethal tumor of the skin, which most commonly occurs in the eyelid. The neoplasm arises from sebaceous glands, such as those of the eyebrow. It represents 1-5.5% of eyelid malignancies and is considered to be the third most common eyelid malignancy after basal cell carcinoma and squamous cell carcinoma, although few reports placed this tumor as second most common after basal cell carcinoma. Cutaneous extra-ocular sebaceous carcinoma is a rare tumor that frequently occurs on the face and scalp, constituting about 25% of all sebaceous carcinoma. It usually affects elderly women and characterized by the high rate of local recurrence, regional and distant metastases. We describe a case of sebaceous carcinoma of the left cheek in an 84-year-old male.

Neoplastic cells with myoepithelial differentiation are often present in both benign and malignant salivary gland neoplasms. Potential diagnostic problems may arise due to morphologic heterogeneity of myoepithelial cell-rich lesions in fine-needle aspiration cytology (FNAC). Myoepithelial carcinoma is a malignant salivary gland tumor composed exclusively of cells with myoepithelial differentiation. Histopathologically, it is a well-established entity but its cytological features have rarely been reported. We report a case of myoepithelial carcinoma of minor salivary gland in a 62-year-old female diagnosed preoperatively by FNAC. Awareness of diverse cytoarchitectural patterns and immunohistochemical profile is crucial for accurate identification.

Small bowel lymphoma is a comparatively rare disease. Usually neither typical nor explicit symptoms are determined during its course and the first manifestation can be noticed when a complication occurs. Burkitt's lymphoma is a high-grade, aggressive and rapidly growing B-cell neoplasm, which has low long-term survival rates. Sporadic Burkitt's lymphoma accounts for 1-2% of lymphomas in adults and for 40% of lymphomas in children in the worldwide population. The abdomen is the most frequent site of onset in nonendemic (sporadic) Burkitt's lymphoma. Symptoms are often misleading and make diagnosis difficult. We present a case of a 5-year-old male child who presented with symptoms of acute intestinal obstruction. Emergency therapeutic and diagnostic laparotomy was performed and biopsy from thickened ileal wall was taken. Histopathologically, it was diagnosed as non-Hodgkin's lymphoma possibly Burkitt's lymphoma and confirmed on immunohistochemistry.

An 18-years old girl presented with progressive diminution of vision and trismus for 3 months. On examination, light perception was absent in the right eye along with decreased vision and lateral ophthalmoplegia in the left eye and Grade 2 trismus. On magnetic resonance image, a large mass, isointense on T1 weighted image with contrast enhancement, hyperintense on T2 weighted image, was seen to be arising from the base of the skull with the surrounding bone and soft tissue destruction. She was initially treated with partial decompression of mass. Histopathological examination showed giant cell tumor. Patient was then treated with radiotherapy. The case is described along with a review of the literature.

Renal cell carcinoma is one of the very few cancers exhibiting spontaneous regression. Within this cohort of patients, late relapse followed by spontaneous regression is extremely rare. This case report vividly illustrates this singular phenomenon.

Primary non-Hodgkin's lymphoma of the breast is a rare entity, comprising <0.5% of all malignant tumors of the breast. They are mainly of the diffuse large B cell lymphoma, while marginal zone B cell lymphomas (MZLs) are exceedingly rare. Links between hepatitis C virus (HCV) infection and several non-Hodgkin lymphomas have been suggested by epidemiological studies. We herein report the first case of low grade MZL of the breast associated with HCV infection showing disease free recurrence following incomplete surgery and antiviral therapy. Nevertheless, the combination of chemotherapy and radiation therapy has been proposed as the gold standard treatment for primary breast lymphoma right now.