ABSTRACT Aim of the Study: To review and suggest treatment approach for rare diseases Leiomyosarcoma of testis. Material and Method: Here, we have reviewed management of Primary Leiomyosarcoma of the testis by search of case reports in PubMed Central, Embase, Cochrane, and Web of Science Central database. We have classified the obtained information as per Oxford Centre for Evidence Based Medicine (OCEBM) level of evidence, and National Comprehensive Cancer Network (NCCN) Categories of Evidence and Consensus. Here, current treatment scenario for sarcoma and its outcome will be discussed for a new case of low grade primary leiomyosarcoma of testis that was confirmed with Immuno-histochemistry after high inguinal orchidectomy, for painless testicular mass. Systematic review, line listing of old reported cases and treatment evidences were analysed by reviewing various international databases. Results: Leiomyosarcoma is a very rare disease, and only few cases have been reported on online databases. It is usually reported among elderly men following irradiation or long-term anabolic steroid use. Intensive search reveals lack of definitive guidelines for management of leiomyosarcoma because available evidence is level V as per OCEBM and level C as per NCCN. Conclusion: Even though early diagnosis and treatment by high inguinal orchidectomy improves survival and decreases risk of recurrence of leiomyosarcoma, there is need of research and definitive chemotherapy guidelines, similar to sarcoma of other site of the...
Objective – Oral cancer is increasing at an alarming rate worldwide and is associated with heightened morbidity and mortality rates. Awareness regarding the signs and symptoms followed by early detection is the key for reducing the same. The present study was taken up to assess the awareness and knowledge regarding oral cancer among dental patients in Bengaluru (INDIA). Method – Study included 400 dental patients who visited the outpatient department of the institution. A questionnaire, adopted and modified from HOCKS scale (mHOCKS), was used to assess the awareness regarding risk factors, knowledge regarding symptoms and signs of oral cancer and general beliefs. Results –The total percentage scores obtained for awareness regarding risk factors, knowledge regarding symptoms and signs of oral cancer and general beliefs of oral cancer were 74.9%, 58.6% and 92.2% respectively. Irrespective of the age and gender, most of the subjects believed that it is easy to treat oral cancer, if detected early. Overall, the score of awareness and knowledge regarding oral cancer in the high-risk population of Bengaluru was, fairly good (75.23%).Conclusion – Although, the study group was having a sound knowledge regarding risk factors, unfortunately knowledge regarding the signs and symptoms of oral cancer was considerably lower. This is especially important for the clinicians, various governmental and non-governmental organization’s in providing specific goals, to concentrate on improving public knowledge about features of oral...
UNVEILING THE MYSTERIOUS WORLD OF SALIVARY DUCT CARCINOMA OF THE PAROTID GLAND- A RARE CASE REPORT AND REVIEW OF THE LITERATURE.
Among many variants of salivary gland tumors, salivary duct carcinoma (SDC) of the parotid gland is a highly aggressive and rare malignant tumor which ranks among those with the worst prognosis and a significant mortality. These tumors got their name based on its microscopic resemblance and being analogous to similar schemes in the ductal carcinoma of the breast. The characteristic microscopic features of salivary duct carcinoma are composed of comedo necrosis, a cribriform and papillary pattern of intraductal growth and aggressive infiltration to adjacent structures. Majority of cases are typically treated with radical parotidectomy with or without neck dissection followed by adjuvant radiotherapy. We present a case of a 60 year old male patient who presented with progressive facial paralysis and right parotid swelling. FNAC was positive for malignancy. PET-CT showed a lesion in right superficial lobe of parotid with bilateral neck nodes. Patient underwent right total parotidectomy with right radical neck dissection and left modified neck dissection. Facial nerve was preserved. Microscopic examination reported it as a salivary duct carcinoma, positive for Her2/neu antibody with lymph node metastasis (22/23). Patient received adjuvant radiotherapy and 12 cycles of Transtuzumab. There were no recurrences or metastases within 12 months of...
Gestational trophoblastic diseases include hydatidiform moles and gestational trophoblastic neoplasia i.e. invasive mole, choriocarcinoma, placental site trophoblastic tumor and epitheloid trophoblastic tumor. Incidence from India has been reported up to 2.4/ 1000 pregnancies, 2.5/ 1000 deliveries and 2.6/ 1000 live births. The standard protocols for management exist and are evolving fast. Though all gestational trophoblastic diseases are not malignant, still these need to be managed intensively, because of their potentially life threatening complications and common occurrence in fertility age group females. The better aspect is that; if timely and standard interventions are made; these are highly curable conditions, even with preservation of reproductive...
Biomarkers are the molecules or tissue based processes that indicate future behavior of the cancer. Broadly classified as tissue-based and blood-based biomarkers, these need special assays over and above the routine clinical, radiological and histopathological examination. Potential of tumor biomarker ranges from risk determination through screening, differential diagnosis, prognosis and prediction to monitoring the disease. Breast cancer is the leading cause of cancer related deaths among women. With progressively better understanding of tumor biology, clinical implications of the molecular behavior are being explored for better therapeutic gains in such patients. Though, to date we have limited range of clinically useful biomarkers in breast cancer; their potential may guide us for cancer therapy in future....
Desmoid tumor is a slow growing neoplasm with aggressive infiltration of adjacent tissue with very rare metastatic potential. We report a 35 years old female patient with desmoid tumor of the anterior abdominal wall who underwent primary resection followed by mesh pasty. Patient had a past history of abdominal surgery in form of caesarean section, and after 5 years of surgery, she presented with a lump over right hypochondrium since last one year. Patient was assessed before surgery by clinical evaluation, abdominal ultrasound, computerized axial tomography scanning (CT scan), magnetic resonance imaging (MRI), and histopathology and immunohistochemistry report.Patient was operated with wide local excision of rectus abdominis muscle mass with meshplasty under general anaesthesia. After all, histology in this case revealed a desmoid tumor with negative β-Catenin report of operated tissue. In view of the negative surgical margins, patient has been put on regular follow...
INCIDENTALLY DETECTED TRANSITIONAL CELL CARCINOMA IN A NONFUNCTIONING KIDNEY: SHOULD WE RELY ON RADIOLOGY?
Abstract: Primary transitional cell carcinoma (TCC) of the renal pelvis is a relatively rare disease and incidentally detected in a non-functioning kidney is much rarer. Herein, we report a case of incidentally detected histopathologically proven case of primary TCC of renal pelvis in a nonfunctioning kidney associated with staghorn calculus.
ROLE OF NATURALLY OCCURRING AGENTS IN TREATMENT OF RADIO-CHEMOTHERAPY INDUCED ORAL MUCOSITIS: A REVIEW
Mucositis is one of the most common side effects of the therapy for the management of cancer; be it radiotherapy, chemotherapy or combination of both. Oral mucositis is of very common occurrence in the patients who are treated for the squamous cell carcinoma of the head and neck region. The therapy targeted towards the oro-pharangeal region most often leads to this side effect. Not only the treatment regimen gets altered sometimes, but the quality of life of the patients also is compromised because of difficulty in normal intake of food. A wide range of mouthwashes, emollients and mucosal barriers have been tried to curb up the sequel of oral mucositis and every product has its limitations; be it the cost or side effects. Naturally occurring products have been available around us since the advent of mankind and various products have been used traditionally for their medicinal properties. This paper attempts to review an array of naturally occurring products which can be utilized for the treatment of radio-chemotherapy induced oral...
IMPACT OF CHRONOMODULATED RADIOTHERAPY ON ACUTE SKIN TOXICITY IN CHEST WALL IRRADIATED BREAST CANCER PATIENTS – A SINGLE INSTITUTION ANALYSIS.
Abstract: We explored the possible association between the timing of delivery of radiation and the grade of skin reaction that develops in breast cancer patients receiving chest wall irradiation as adjuvant treatment after modified radical mastectomy. Invasive breast cancer patients, registered during the period of January 2013 – December 2014, who had undergone modified radical mastectomy followed by chest wall irradiation, were eligible for inclusion to the study. All the patients received chest wall external beam radiotherapy (EBRT) to a dose of 50 Gy in 25 fractions, one fraction a day, five days a week, delivered as tangential opposed pair, from a Cobalt 60 teletherapy source. Patients were stratified based on whether they received EBRT in the morning (between 8 am – 11 am) or in the evening between (5 pm – 8 pm). The clinicopathological characteristics of patients in both the arms were relatively well balanced. The incidence of higher grade of skin reaction (grade 3 or 4) was 22.5 % compared to 35.7 % in the morning and evening arms respectively, which was statistically significant (p = 0.039). The time to development of Grade 3 or 4 toxicity was 4.44 weeks compared to 4.11 weeks in the morning and evening arms respectively, suggesting that higher toxicity developed earlier in the patients receiving EBRT in the evening, though not statistically significant (p =...
A RETROSPECTIVE ANALYSIS OF PALLIATIVE SURGICAL PROCEDURES FOR ADVANCED MALIGNANCIES IN A PRIVATE TERTIARY CANCER CARE CENTER.
Palliative surgery is an important, yet understudied aspect of palliative care. The present article emphasizes the diversity of palliative surgical procedures performed at a private tertiary cancer care center in India and the need of the multidisciplinary approach towards it. Though the overall morbidity and mortality is high, a significant number of cancer patients are alleviated from their symptoms and have a better quality of life, even in those with an anticipated short...