Context: Oral cancer is the sixth most common cause of cancer-related deaths worldwide. In the Indian scenario, oral cancer is the second most common cancer. The presence of metastatic cervical lymphadenopathy is of particular importance as with every single nodal metastasis, survival of the patient is reduced by one half. Thus, regional metastasis is one of the most important factors in the prognosis and treatment planning of patients with head and neck squamous cell carcinomas. The inaccuracies in clinical examination have been well documented and the diagnostic imaging modalities have been shown to have superior diagnostic accuracy in detecting occult nodal metastasis Considering the numerous uncertainties regarding the progression, management and outcome of oral cancers, an attempt was made to detect the role of tumor size as a predictive indicator for lymph node metastasis using magnetic resonance imaging (MRI). Aim of the Study: The aims of the present study was to evaluate tumor size and its relation to cervical lymph node metastasis and its significance as a prognostic indicator for oral squamous cell carcinomas (OSCCs); and to identify and evaluate inaccuracies of the clinical diagnostic criteria with the help of magnetic resonance imaging (MRI). Materials and Methods: A total number of 27 patients (12 oral cancer-alveolus, 8 oral cancer-tongue, 7 oral cancer-buccal mucosa) attending as out-patients were included in the study. The patients clinically diagnosed and histopathologically proven to have oral squamous cell carcinoma were examined and were evaluated for the tumour size and lymph node status with the help of MRI. Statistical Analysis Used: Values of sensitivity, specificity, positive and negative predictive values and accuracy were calculated. Paired t-test was performed for evaluating size of the tumor and lymph node recorded on clinical and imaging findings. Results: 40% cases were found to be true positive for detecting metastasis using clinical diagnostic criteria whereas 55% cases were found to be true positive for detecting metastasis using imaging criteria. The paired t-test value for the difference in tumor size between clinical and imaging staging was statistically significant (P < 0.01). The paired t-test value for the difference in lymph node size between clinical and imaging staging was, also, found to be statistically significant (P < 0.01). Overall specificity of 100%, sensitivity of 75%, positive predictive value 72%, negative predictive value 100% and accuracy of 85% were noticed for imaging staging. Conclusion: Detection of tumor size and lymph node metastasis was found to be higher on MRI than that by clinical staging alone. The present study, also, proved that clinical diagnostic criteria alone are less accurate for detecting metastatic lymphadenopathy. MRI, thus, can be safely made a recommendation in all head and neck malignancies for preoperative diagnostic imaging procedures in order to get extremely useful information regarding treatment planning and prognosis in such patients presenting with oral carcinomas.

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Phyllodes tumors are rare breast tumor types and comprise 0.3%–1.0% of all breast tumors. They usually manifest in 35–55-year age group and are classified into benign, borderline, and malignant types based on the histopathological features. Certain cases of malignant tumors behave in an aggressive manner with an unpredictable and often dismal outcome. The present case report addresses such a scenario in a very young female who showed a rapid appearance of brain metastatic disease. We describe this case and present a brief literature review.

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Colitis cystica profunda is a rare benign condition of the rectum and colon and is characterized by benign intramural mucous containing glands. It can be easily misdiagnosed as invasive adenocarcinoma clinically as well as on imaging modalities. The definite diagnosis can only be made on histopathology. We present a case of 50-year-old male who came with the complaints of intermittent abdominal pain and abdominal distension.

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Epidermodysplasia verruciformis (EV) is an extremely rare autosomal recessive genodermatosis characterized by abnormal susceptibility to human papilloma virus (HPV) infection. The inability to terminate HPV infection leads to widespread and persistent wart-like and macular skin lesions. The extent of cutaneous inivolvement and progress of the lesions vary considerably, but the persistence of skin lesions throughout the life is a characteristic feature of EV. The interaction among potentially oncogenic HPV genotypes, ultraviolet radiation, altered immunity, and genetic factors will lead to the development of nonmelanoma skin cancers in 30%–60% of cases. Although there is lifelong increased risk of squamous cell carcinoma, the association with hematological or solid malignancies is rare. Literature search shows very few isolated reports of non-Hodgkin's lymphoma, astrocytoma, thymoma, adenocarcinoma intestine, and leiomyosarcoma in patients with EV. Herein, we report a case of EV with an uncommon occurrence of peripheral T-cell lymphoma, squamous cell carcinoma, and Langerhans cell histiocytosis. EBV-associated squamous cell carcinoma carries increased number of viral proteins and this may play role in cell immortalization, chromosomal destabilization, and activation of telomerase. The development of lymphoma and Langerhans cell histiocytosis may be due to the defect in immune system and due to the oncogenic potential of the virus. These point to the importance of regular long-term follow-up of EV patients for the possible cutaneous and extracutaneous malignancy.

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Introduction: Stomach cancer is the third leading cause of cancer related deaths in either sex. Compared to world statistics, India has a lower incidence and prevalence of this cancer. The diversity in dietary habits accounts for regional variations in incidence of stomach cancers across different parts of India. In this retrospective audit, we have tried to analyze the epidemiology of gastric cancers of northern India which were treated in our institution. Material and Methods: Review of the Hospital Based Cancer Registry (HBCR) of PGIMER, Chandigarh showed that 156 stomach cancer patients (only adenocarcinoma and signet ring cell histopathologies included) were treated from August 2012 to December, 2016. Descriptive statistics were employed for analyzing results. Results: The median age of patients was 52 years with a predilection for male sex. Mostly patients were alcoholics (53.2%) but nonsmokers (59.6%). More than 70% patients ate fruits and vegetables and did not consume processed meat. Anorexia and weight loss was the commonest presenting complaint. The commonest stages observed were stage IIIC (21.1%) and IIB (19.2%). More than 90% patients had adenocarcinoma of which intestinal variant was the commonest. Subtotal gastrectomy with D1 lymph node dissection was practiced more than total gastrectomy and/or D2 dissection. Conclusions: Our patients belonged to a low risk population for gastric cancer mostly due to protective dietary habits. Further reports can give better insight into the epidemiological diversity of this cancer.

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