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   2008| July-September  | Volume 45 | Issue 3  
    Online since November 14, 2008

 
 
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CASE REPORTS
Squamous cell carcinoma of tongue in a 19-year-old female
T Randhawa, PM Shameena, S Sudha, RG Nair
July-September 2008, 45(3):128-130
DOI:10.4103/0019-509X.44071  PMID:19018119
Squamous cell carcinoma is the most common malignant neoplasm of the Oral Cavity, usually affecting individuals over 50 years of age. It rarely occurs in patients who are less than 40 years old (0.4-5.5%). However, since it is so rare, when cases occur they are often misdiagnosed and inappropriately treated leading to delay in definitive treatment. This report describes a case of squamous cell carcinoma, involving the posterolateral border of the tongue of a 19-year-old female patient, with no deleterious habits usually associated with oral cancer. This report focuses on the etiological factors and prognosis related to the case. Additionally, a brief literature review regarding squamous cell carcinoma in young patients is also included.
  8,672 599 12
ORIGINAL ARTICLES
Changing trends in oral cancer
N Sherin, T Simi, PM Shameena, S Sudha
July-September 2008, 45(3):93-96
DOI:10.4103/0019-509X.44063  PMID:19018111
Context: No study highlighting the incidence of oral squamous cell carcinoma (OSCC) in young adults has been reported from North Kerala until now. Aims: To study the cases of OSCC reported at our institution, with emphasis on the clinicopathologic variables in young adults. Settings and Design: This was a retrospective study of OSCC cases reported from 2002 to 2007. Materials and Methods: Data of oral cancer cases reported between 2002 and 2007 were retrieved from the records. The cases in patients below 40 years of age formed a separate study group. The data obtained was tabulated and comparisons drawn on the observed variables between the two groups. Results: Results showed a high incidence of OSCC among young adults. The demographic and anatomic location of these cases showed significant variations from cases of oral cancer in older patients. In addition, a significant number of these cases failed to show any relation with the commonly implicated etiologic agents of oral cancer. Conclusion : The findings of our study indicate a high incidence of oral cancer among young adults in our region. The tongue is the most common site in these cases with a significant number showing no possible etiological factors.
  6,936 1,255 33
Tobacco consumption among adolescents in rural Wardha: Where and how tobacco control should focus its attention?
AR Dongre, PR Deshmukh, N Murali, BS Garg
July-September 2008, 45(3):100-106
DOI:10.4103/0019-509X.44065  PMID:19018113
Objectives: The objectives of the present study were to study the pattern of tobacco use among rural adolescents (15-19 years) and to find out reasons for use and non use of tobacco products. Materials and Methods : In the present community-based research, triangulation of qualitative (free list, focus group discussions) and quantitative methods (survey) was undertaken. The study was carried out in surrounding 11 villages of the Kasturba Rural Health Training Centre, Anji during January 2008 where 385 adolescents were selected by simple random sampling and interviewed by house to house visits. After survey, six focus group discussions were undertaken with adolescent boys. Results: About 68.3% boys and 12.4% girls had consumed any tobacco products in last 30 days. Out of boys who had consumed tobacco, 79.2% consumed kharra, and 46.4% consumed gutka. Among boys, 51.2% consumed it due to peer pressure, 35.2% consumed tobacco as they felt better, and five percent consumed tobacco to ease abdominal complaints and dental problem. Among girls, 72% used dry snuff for teeth cleaning, 32% and 20% consumed tobacco in the form of gutka and tobacco & lime respectively. The reasons for non use of tobacco among girls were fear of cancer (59%), poor oral health (37.9%). Among non consuming boys it was fear of cancer (58.6%), poor oral health (44.8%) and fear of getting addiction (29.3%). According to FGD respondents, few adolescent boys taste tobacco by 8-10 years of age, while girls do it by 12-13 years. Peer pressure acts as a pro tobacco influence among boys who are outgoing and spend more time with their friends. They prefer to consume freshly prepared kharra which was supposed to be less strong (tej) than gutka. Tobacco is being used in treatment of some health problems. Tobacco is chewed after meals for better digestion, given to ease toothache, pain in abdomen and to induce vomiting in suicidal insecticide poisoning. Conclusion: The current consumption of any tobacco products among rural adolescents was found very high. Hence, the multi-pronged intervention strategy is needed to tackle the problem.
  6,361 690 21
REVIEW ARTICLES
Neoadjuvant chemotherapy or chemoradiotherapy in head and neck cancer
Preetesh Jain, Prabhash Kumar, Vasanth Raghuvir Pai, Purvish Mahendra Parikh
July-September 2008, 45(3):83-89
DOI:10.4103/0019-509X.44061  PMID:19018109
The multidisciplinary approach to treating squamous cell carcinoma of the head and neck is complex and evolving. Chemotherapy is increasingly being incorporated into the treatment of squamous cell carcinoma of the head and neck. Previously, radiotherapy following surgery was the standard approach to the treatment of loco regionally advanced resectable disease. Data from randomized trials have confirmed the benefits of concurrent chemo radiotherapy in the adjuvant setting. Chemo radiotherapy is also the recommended approach for unresectable disease. Advanced loco regional disease is the most frequent clinical situation in Head and Neck cancer. The standard of care for most clinicians is a multidisciplinary treatment with concomitant chemotherapy plus radiotherapy (CRT). However, retrospective studies have shown that in patients treated with CRT there was a relative increase in systemic relapse due to a lack of systemic control. For this reason a renewed interest has appeared for the incorporation of induction chemotherapy in the treatment of locally advanced Head and Neck Cancer. Furthermore new combination regimens with taxanes have shown to be more active than the classical cisplatin and 5-fluorouracil induction regimen. Novel targeted agents, such as epidermal growth factor receptor antagonists, are showing promise in the treatment of patients with both loco regionally advanced and recurrent/metastatic squamous cell carcinoma of the head and neck.
  5,905 904 15
Clinical Trials Registry - India: Redefining the conduct of clinical trials
A Pandey, AR Aggarwal, SD Seth, M Maulik, R Bano, A Juneja
July-September 2008, 45(3):79-82
DOI:10.4103/0019-509X.44060  PMID:19018108
  6,165 565 13
ORIGINAL ARTICLES
Predictors of quality of life in breast cancer patients under chemotherapy
A Safaee, B Moghimi-Dehkordi, B Zeighami, HR Tabatabaee, MA Pourhoseingholi
July-September 2008, 45(3):107-111
DOI:10.4103/0019-509X.44066  PMID:19018114
Background: Today, the quality of life studies has an important role in health care especially in chronic diseases. Breast cancer has third order among women's malignancies. Now, survival rate for this cancer is long. However breast cancer has several complications that affected the patient's life. Aims : The aim of this study was to assess the quality of life in Breast cancer patients under chemotherapy. Setting and Design: A cross-sectional study conducted on 119 breast cancer patients that were admitted and treated in chemotherapy ward of Namazi hospital in Shiraz city, south of Iran, between Jan and Feb 2006. Materials and Methods: The QLQ-C30 questionnaire was used to assess quality of life in these patients. Statistical Analysis: We used univariate methods. A multiple regression analysis was performed to identify predictors of quality of life. Results: Mean age of patients was 48.2711.42 with quality of life total score 64.9224.28. All symptoms scales had reverse association with quality of life except appetite loss (P>0.05) and diarrhea (P=0.752). The results of the regression analyses showed that only grade of tumor, occupational status, menopausal status, financial difficulties and dyspnea were statistically significant in predicting patients' quality of life. Conclusion: In conclusion, this study demonstrates the strength of the relationship between clinical and sociodemographical factors and breast cancer patients' quality of life. Psychological and financial support for women experiencing breast cancer diagnosis may improve quality of life.
  5,618 740 28
Primary central nervous system lymphomas: Indian experience, and review of literature
TR Paul, S Challa, A Tandon, MK Panigrahi, AK Purohit
July-September 2008, 45(3):112-118
DOI:10.4103/0019-509X.44067  PMID:19018115
Primary central nervous system lymphomas (PCNSLs) are a rare form of non-Hodgkin's lymphoma which arise within and remain confined primarily to the central nervous system (CNS). They generally account for 1-2% of all primary brain tumors and are reported to be on the rise due to the Acquired Immune Deficiency Syndrome (AIDS) epidemic. Aims and Objectives: To study the clinicopathological and immunophenotypic characteristics of PCNSLs and look for any differences in PCNSLs reported in India from those in other countries. Materials and Methods : All cases of PCNSLs between January 1998 and December 2006 were reviewed. Presence of lymphadenopathy, organomegaly and bone marrow study was done to exclude the possibility of secondary involvement by lymphoma. The diagnosis was confirmed by histopathology with Hematoxylin and Eosin and reticulin stains. Immunohistochemistry (IHC) with leucocyte common antigen (LCA), CD 20 and CD 3 was performed on available blocks. The immune status was evaluated by clinical examination and human immunodeficiency virus (HIV) serology (since 1996). Results : In a 19-year study period, there were 56 patients of PCNSLs, accounting for 1.07% of all intracranial neoplasms. The patients ranged from 10-75 years of age with a median age of 42 years. Barring one patient who was HIV positive, all the others were immunocompetent. All cases were diffuse large cell lymphomas on histopathology. IHC with LCA and CD 20 revealed positivity in 100% and 86.4% cases respectively. There was a single case of CD 3 positive T-cell lymphoma. In the present study, PCNSLs occurred in young immunocompetent patients and majority were diffuse large B cell lymphomas.
  4,127 706 10
Pediatric carcinoma of rectum - Varanasi experience
A Pandey, AN Gangopadhyay, SP Sharma, V Kumar, DK Gupta, SC Gopal, RB Singh
July-September 2008, 45(3):119-122
DOI:10.4103/0019-509X.44068  PMID:19018116
Background : Primary gastrointestinal system malignancies constitute approximately 2% of pediatric neoplasm and of these; colorectal carcinoma is the second most common malignancy. This is one of the rarer diseases in children. Aim : We reviewed our records to study the clinical features, outcome and the follow-up of this condition with evaluation of the prognostic factors. Settings and Design: Tertiary care Pediatric Surgery centre. Retrospective study. Materials and Methods : The data of all patients with diagnosis of colorectal carcinoma from January 1986 to January 2006 were reviewed. The confirmation of the diagnosis was by biopsy from the lesion. The age, sex, family history, clinical features, response to the treatment and follow-up were studied. Results : There were four male patients. All had bleeding per rectum as the presenting complaint. Three patients had advanced disease at presentation. All the patients had signet cell adenocarcinoma. The two patients expired and one was lost to follow-up. One patient is alive after one year of follow up and is receiving treatment. Conclusion : Colorectal cancer in children though rare can be a reality, hence any children presenting with pain in abdomen along with doubtful history of constipation and rectal bleeding should be examined carefully with special emphasis on digital rectal examination.
  3,357 337 4
LETTERS TO EDITOR
Fever and leukemoid reaction: A rare paraneoplastic manifestation of bladder carcinoma
R Mongha, S Narayan, RK Das, AK Kundu
July-September 2008, 45(3):131-132
DOI:10.4103/0019-509X.44072  PMID:19018120
  2,925 299 3
ORIGINAL ARTICLES
Oxidative stress in patients with laryngeal carcinoma
RC Dwivedi, DP Raturi, N Kandpal, RC Dwivedi, RP Singh, VN Puri
July-September 2008, 45(3):97-99
DOI:10.4103/0019-509X.44064  PMID:19018112
Background : Cancer is a multifactorial disease. Repetitive cumulative damage of cellular organelles by oxy-free radicals are few of the important causative factors. Aim : To assess the role of oxidative stress in the laryngeal cancer patients in Indian population. Setting and Design : Case control study. Materials and Methods : Level of malondialdehyde (MDA) as a marker of oxidative stress was examined in large cohort of control (50) and laryngeal carcinoma patients (155) from North India. Both the controls and laryngeal carcinoma patients were smokers. Results : In control healthy subjects MDA levels were 0.1020.07 (0.080- 0.303, 95% CI) n mol/ml, as compared to 0.3290.16 (0.124-0.354, 95% CI) n mol/ml in the cases of laryngeal carcinoma patients. Three times higher serum MDA levels indicated that there was significant oxidative stress in the subjects having laryngeal carcinoma lesions. In addition patients with secondaries were having MDA levels of 0.40.02 (0.391-0.408 95% CI) n mol/ml, as compared to 0.570.03 (0.558-0.582 95% CI)n mol/ml in group of patients without secondaries. These two values were statistically significant as compared to control values (P<0.01). Conclusion : These findings suggest that in case of laryngeal carcinoma patients, there is increase in the level of oxidative enzyme MDA. The oxidative stress might be due to the modulation of pro-oxidant or anti-oxidant systems in laryngeal carcinoma.
  2,778 348 8
REVIEW ARTICLES
Squamous cell carcinoma of the head and neck region: Insights from the American Society of Clinical Oncology 2008 presentations
C Desai
July-September 2008, 45(3):90-92
DOI:10.4103/0019-509X.44062  PMID:19018110
  2,623 390 3
CASE REPORTS
Heterotopic bone formation in renal cell carcinoma: A diagnostic challenge
V Singh, RJ Sinha, SN Sankhwar, D Dalela
July-September 2008, 45(3):126-127
DOI:10.4103/0019-509X.44070  PMID:19018118
Formation of bone in cases of renal cell carcinoma is a rare finding and only a couple of case reports from Japan and one from India are mentioned in the literature. Calcification inside renal mass has been reported earlier but the prognostic implications have not been clearly elucidated. We report a case which showed heterotopic bone formation (ossification) inside the renal mass and was managed by radical nephrectomy. The histopathology showed clear cell renal carcinoma with multiple centers of ossification in the region of calcification suggesting bone formation. In this case report we discuss bone morphogenetic proteins which have been implicated as a prognostic and causative factor, highlight the difficulties in distinguishing between calcification and bone formation on the basis of radiological investigations and mention the geographic implications of this rare phenomenon which has not been described earlier.
  2,294 291 3
Leiomyosarcoma of the maxilla as second malignancy in retinoblastoma
SS Qureshi, RC Mistry, G Natrajan, S Gujral, S Laskar, S Banavali
July-September 2008, 45(3):123-125
DOI:10.4103/0019-509X.44069  PMID:19018117
Patients with hereditary retinoblastoma are at increased risk of second primary tumor, the commonest tumor being osteosarcoma. Leiomyosarcoma developing as second primary neoplasm in retinoblastoma patients is unusual and most have occurred in the field of previous radiotherapy. Although with aggressive therapy better survival can be achieved, the overall prognosis of patients developing these second neoplasms is poor. In this report we present a case of leiomyosarcoma of the maxilla as a second neoplasm in a patient with bilateral retinoblastoma which has developed outside the radiation field.
  2,243 311 3
LETTERS TO EDITOR
Sole acquired trisomy 21 in a case of CD7 and CD10 positive acute myeloid leukemia
R Naithani, D Singhal, R Kumar, V Raina, R Saxena, H Anand
July-September 2008, 45(3):132-134
DOI:10.4103/0019-509X.44073  PMID:19018121
  2,278 248 2
Recurrent Kangri cancer treated with external beam radiotherapy on a cobalt unit
MA Teli, MA Darzi, M Gupta, SS Katoch
July-September 2008, 45(3):134-135
DOI:10.4103/0019-509X.44074  PMID:19018122
  1,860 205 -
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