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.
Background- Astroblastoma is partially understood, poorly reported and rare in occurrence tumor with significant dilemma regarding cellular origin, diagnostic criteria, clinical behavior, and management protocol. Material and method– Thorough search of published English scientific literature was made with search word Astroblastoma through Google Search, PubMed, Research Gate and Cochrane Library till June 2018. The reports thus collected were examined for data regarding age, gender, location and laterality of disease, pathological grade, treatment received, and outcome of treatment. Results– Data of 161 patients was retrieved from 72 publications. Median age at presentation was 18 years. Females were affected much more frequently than males. Most common site of involvement was the frontal lobe. Laterality data was inconsistent and sparingly reported. Most common presenting complaint was headache followed by history of seizure. Surgery was performed in majority of patients-79.6% of the patients underwent a gross total resection, 45% (44 out of 98 reported) had a high-grade tumor. Sixty patients received adjuvant radiation with a median dose of 54 Gy (Range 20-72), mostly for high grade, residual or recurrent disease. Adjuvant chemotherapy was used in 25 patients. Median follow-up was 43 months (range 1-238). Median overall survival was 138 months. Patients with a higher-grade tumor had significantly worse overall survival. Conclusion- Astroblastoma is rare but known to have two distinct grades, with higher-grade tumors bearing significantly poor survival. Maximal safe surgery is the standard. Though there is lack of consensus, adjuvant radiotherapy with or without Temozolamide should be considered in view of high rates of local...
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...
MIXED GERM CELL TUMOR OF OVARY AND MAYER ROKITANSKY KUSTNER HAUSER SYNDROME: AN UNUSUAL COMBINATION!
Germ cell tumor of ovary in young female is most common ovarian neoplasm but represent less than three percent of all ovarian malignancies in females. Mixed germ cell tumor is a variant of germ cell tumors and its presentation with Mayer Rokitansky Kustner Hauser Syndrome, which represents the most common type of utero-vaginal agenesis, is very unusual. However, for patients with primary amenorrhea, Mayer Rokitansky Kustner Hauser syndrome is the second common cause. We describe an interesting, uncommon and unexpected case in a young Indian female patient with primary amenorrhea due to this syndrome coexisting with mixed germ cell...
Partial nephrectomy is performed more commonly for small, low-stage renal tumors. The main advantage of partial nephrectomy over radical nephrectomy is the avoidance of renal insufficiency. The major disadvantages are the possibility of local recurrence and perioperative complications. In this article, we discuss the technical aspects of the nephron-sparing surgery and review the literature pertaining to it, in order to put the management of renal cancer into a modern...
CONCOMITANT CHEMORADIATION IN LOCALLY ADVANCED CARCINOMA CERVIX: COMPARING DOUBLET VERSUS SINGLE AGENT CHEMOTHERAPY.
Abstract Purpose: To compare the efficacy and toxicity of two definitive concomitant chemoradiotherapy schedules (doublet combination and single agent) along with radical external beam radiotherapy (EBRT) in the management of locally advanced carcinoma of the uterine cervix (LACCx). Material and method: Previously untreated, 60 patients of LACCx (FIGO stage IIB-IIIB) were taken for definitive treatment by concurrent chemo-radiation. These patients were randomly assigned either; Study group I, the Doublet chemotherapy(Gemcitabine + Cisplatin) administration and Control group II, the Single-agent chemotherapy(Cisplatin) administration group. EBRT was given as 50Gy/ 25Fr/ 5 weeks. Chemoradiation was followed by weekly HDR Intra-cavitory brachytherapy (ICBT), 3 sessions of 700cGy each. Observations were made at the end of treatment and 6 months of follow up. Response to treatment and toxicity were investigated. Results: At the end of treatment, disease response in study and control respectively at the end of treatment was as follows: Stage IIB (CR- 52.63% versus 38.09%), Stage IIIA (CR- 100% versus 100%) and Stage IIIB (CR- 55.56% versus 25.0%). Overall disease response for the group I and II, at the end of sixth months follow up was as follows: CR- 93.33% versus 83.33%, PR- 3.33% versus 13.33%, and recurrence- 3.33% versus 3.33% respectively. Most severe acute hematological toxicity observed was Grade 2 in 40.0% versus 16.67% patients, respectively. Similar was the trend of acute skin & mucosal reactions and acute gastrointestinal toxicity. Though a higher number of patients in the study group experienced more acute toxicities, these were acceptable and manageable. Skin and mucosal reactions at 6 months follow up were not significantly higher in the doublet group compared to the single agent group. Conclusion: Administration of doublet combination chemotherapy; is better compared to single-agent chemotherapy administration in terms of disease control (though not statistically significant)with manageable toxicity profile; given concurrent with EBRT, for management of locally advanced carcinoma cervix. A larger study may establish the very role of the new regimen, especially in a resource-limited setup where patients present with advanced/ bulky...
Disease and treatment-related swallowing dysfunction are quite common in head and neck malignancies. Though the use of high-end technology like Intensity modulated radiotherapy (IMRT) has led to a reduction in morbidity still, the issue of tolerability comes whenever a higher dose of radiation is used for tumor control. The goal of this review is to emphasize the need for documentation of pretreatment swallowing functions and look into the prospects to improve swallowing function, thence quality of life after radiotherapy by studying factors leading to this impairment. We also looked into the benefit of physiotherapy exercises to increase the capacity of...
Background: Immediate breast reconstruction (IBR) in breast cancer is a well-accepted option but is not commonly offered in India. The purpose of this study is to evaluate the quality of life after IBR. Materials and methods: This prospective study has been conducted over 40 patients of operable carcinoma breast, who underwent either modified radical mastectomy (MRM) in control group or MRM followed by IBR using autologous tissue in the study group. Both the groups were evaluated in terms of technical issues, morbidity, clinical outcome and quality of life (QoL). The psychological satisfaction in either group was studied by body image scale. Results: In the postoperative period, complication rate of 35% was noted in the study group as compared to 10% in the control group. In the study group, 95% of the patients were satisfied with the body image. Among these, 20% of patients were highly satisfied, 75% were moderately satisfied. On the other hand, 80% of the patients undergoing MRM alone were not satisfied at all. Conclusion: Immediate breast reconstruction following mastectomy is a logically better option to preserve the femininity, gives a higher level of patient satisfaction and significantly improves the quality of...
Abstract Nodular hidradenoma or clear cell hidradenoma is a rare skin adnexal tumor arising from eccrine sweat glands. Skin adnexal tumors situated in breast parenchyma are very rare and is one of differential diagnosis of breast masses. We report a case of 60 years old female with a left breast lump and bloody nipple discharge being suspected as a malignant breast mass. A final diagnosis of nodular hidradenoma breast was made after excision biopsy and immunohistochemistry study. A patient is a diagnosed case of carcinoma endometrium and underwent panhysterectomy in 2007. Postoperative histopathology revealed well-differentiated endometrial adenocarcinoma without invasion of the myometrium. She received postoperative radiation therapy and intravaginal brachytherapy in 2008 and is on regular follow-up since...
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...