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   2013| October-December  | Volume 50 | Issue 4  
    Online since December 24, 2013

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Reproductive factors and breast cancer: A case-control study in tertiary care hospital of North India
AS Bhadoria, U Kapil, N Sareen, P Singh
October-December 2013, 50(4):316-321
DOI:10.4103/0019-509X.123606  PMID:24369207
Background: Clinical, animal, and epidemiological studies have clearly demonstrated that cancer is a hormonally mediated disease and several factors that influence hormonal status or are markers of change in hormonal status have been shown to be associated with the risk of breast cancer. Aims: To identify the association of various reproductive factors with breast cancer. Settings and Design: A hospital-based, matched, case-control study. Materials and Methods: Three hundred and twenty newly diagnosed breast cancer cases and three hundred and twenty normal healthy individuals constituted the study population. The subjects in the control group were matched individually with the cases for their age ± 2 years and socioeconomic status. A pre-tested, semi-structured questionnaire was administered to each individual to collect information on identification data, socio-demographic profile, and reproductive factors. Statistical Analysis Used: The Chi-square test and unpaired t-test were used. The conditional univariate logistic regression analysis (unadjusted odds ratio and confidence intervals) was used to calculate the significance level of each variable followed by multivariate regression analysis. Results and Conclusions: The cases had a lower mean age at menarche, higher age at marriage, higher mean age at last child birth, lower mean duration of breastfeeding, higher number of abortions, late age at menopause, history of oral contraceptive pills, and a family history of breast cancer as compared to the controls. The results of the present study revealed a strong association of reproductive factors with breast cancer in the Indian population.
  20,221 1,127 15
Histogenesis of salivary gland neoplasms
N Dwivedi, A Agarwal, V Raj, S Chandra
October-December 2013, 50(4):361-366
DOI:10.4103/0019-509X.123629  PMID:24369218
Salivary gland tumors are one of the most complex and relatively rare group of lesions encountered in oral pathology practice. Their complexity is attributed to heterogeneity of the cells of origin of these lesions. The problem is compounded by the ability of these cells to differentiate and modify into various morphological subtypes resulting in a myraid of histomorphological patterns. This also leads to a frequent overlap of microscopic features among various neoplasms and sometimes even between benign and malignant lesions causing significant diagnostic dilemma which sometimes may even not be resolved by immunohistochemical studies. Despite this the knowledge of histogenesis and morhogenetic concepts of salivary gland tumorigenesis greatly helps the pathologist in classifying these lesions as well as determining the prognosis. It will also help in development of newer strategies for differentiating these lesions and making an early diagnosis. The present article is aimed at reviewing and summarizing the current concepts regarding the histogenesis of salivary gland tumors and their relevance to routine diagnosis and classification of these lesions.
  11,833 2,111 3
A Phase 3, randomized, double-blind study of single-dose fosaprepitant for prevention of cisplatin-induced nausea and vomiting: Results of an Indian population subanalysis
A Maru, VP Gangadharan, CJ Desai, RK Mohapatra, AD Carides
October-December 2013, 50(4):285-291
DOI:10.4103/0019-509X.123580  PMID:24369195
Context: Currently, there is limited data on the prevention of chemotherapy-induced nausea and vomiting (CINV) in Indian patients. Aims: This post hoc study assessed the efficacy and safety of fosaprepitant compared with aprepitant for prevention of CINV in the Indian population. A subgroup analysis was performed from data collected in a phase 3 study of intravenous (IV) fosaprepitant or oral aprepitant, plus the 5-HT 3 antagonist ondansetron and the corticosteroid dexamethasone, in cisplatin-naοve patients with solid malignancies. Materials and Methods: Patients scheduled to receive cisplatin (≥70 mg/m 2 ) were administered a single IV dose of fosaprepitant dimeglumine (150 mg) on day 1 or a 3-day dosing regimen of oral aprepitant (day 1:125 mg, days 2 and 3:80 mg) with standard doses of ondansetron and dexamethasone. Patients recorded nausea and/or vomiting episodes and their use of rescue medication and were monitored for adverse events (AEs) and tolerability. Statistical Analysis Used: Differences in response rates between fosaprepitant and aprepitant were calculated using the Miettinen and Nurminen method. Results: In the Indian subpopulation (n = 372), efficacy was similar for patients in both the fosaprepitant or aprepitant groups; complete response in the overall, acute, and delayed phases and no vomiting in all phases were approximately 4 percentage points higher in the fosaprepitant group compared with the aprepitant group. Fosaprepitant was generally well-tolerated; common AEs were similar to oral aprepitant. Conclusions: IV fosaprepitant is as safe and effective as oral aprepitant in the Indian subpopulation and offers an alternative to the oral formulation.
  3,869 9,652 4
Role of extracorporeal irradiation in malignant bone tumors
DN Sharma, S Rastogi, S Bakhshi, GK Rath, PK Julka, MA Laviraj, SA Khan, A Kumar
October-December 2013, 50(4):306-309
DOI:10.4103/0019-509X.123601  PMID:24369205
Aims and Objectives: Extracorporeal irradiation (ECI) is relatively a rare method used in the management of malignant bone tumors (MBT). It consists of en-bloc removal of the tumor bearing bone segment, removal of the tumor from the bone, irradiation, and re-implantation back in the body. We report our preliminary experience of using ECI for management of MBT. Materials and Methods: From year 2009 to 2010, 14 patients with primary MBT were enrolled into this study. The eligibility criteria included histopathological proof of malignancy, no evidence of distant metastases, and suitability for limb preservation therapy. Surgery was performed about 4 weeks after completion of neoadjuvant chemotherapy. The affected bone segment was resected, irradiated extracorporeally with a dose of 50 Gy and reimplanted. Local control, complications and short-term survival were studied. Functional outcome was assessed by Musculoskeletal Tumor Society (MSTS) scoring system. Results: There were 10 males and four females with median age of 14 years. Histopthologically, nine patients had osteosarcoma (OS) and five had Ewing's sarcoma family of tumors (ESFT). Distribution of primary site was as follows: Femur eight patients, tibia five patients and humerus one patient. At a median follow-up was 22 months, three patients (two OS, one ESFT) had local recurrence. Two patients (14%) developed wound infection in the perioperative period. The 2 year local recurrence free survival was 73% and mean MSTS score was 88. Conclusion: Results of our study suggest that ECI is technically feasible in the management of MBT and provides decent local control and short-term survival rates.
  7,196 683 4
Colorectal cancer in young adults in a tertiary care hospital in Chhattisgarh, Raipur
V Sudarshan, N Hussain, R Gahine, J Mourya
October-December 2013, 50(4):337-340
DOI:10.4103/0019-509X.123621  PMID:24369213
Context: Carcinoma of the colon and rectum is a relatively uncommon malignancy in India when compared with the western world. Colorectal cancer is generally a disease affecting individuals 50 years of age and older and is much less common in persons under 40 years of age. It is also a very uncommon pediatric malignancy. Aims: To study the age, gender, site of primary tumor, histopathological type, and pathologic stage of colorectal cancer cases with specific reference to young adults. Settings and Design: Tertiary care hospital, Retrospective study. Materials and Methods: We conducted a retrospective study of all colorectal carcinomas (CRC) which were diagnosed during the past 8 years i.e., from January 2003 to December 2010. Patients were divided in to two groups - 40 years and younger, and older than 40 years. The records were analyzed in detail for age, gender, site of primary tumor, histopathological type, and pathologic stage. The results of the two groups were compared and also with information from other centers. Statistical Analysis Used: Nil. Results: Two hundred and thirty three patients were diagnosed to have CRC. Patients diagnosed below 40 years of age comprised 39.05% and those under age 20 comprised 4. 29%. Among those under 40 years of age, majority were males (63.73%), most occurred in the rectum (84.61%). Most of them were poorly differentiated mucin-secreting adenocarcinomas (80.21%) and presented at advanced pathologic T stage (71.42%). This was similar to those reported in other literatures. However, the incidence of colorectal cancer in patients younger than 40 years is much more in our study when compared with reports from other places. Conclusions: CRC in our institution is more often seen in younger individuals than what is reported in population-based cancer registries from other parts of the country. The reasons for this are not clear. Therefore, further studies are required to address the role of diet and personal habits with CRC in this region. Also, a high index of suspicion among young adults is necessary.
  6,835 683 5
The importance of immediate verification of a cervical cytological abnormality with histology
C Kabaca, B Sariibrahim, I Keleli, A Karateke, S Cesur, H Cetiner
October-December 2013, 50(4):292-296
DOI:10.4103/0019-509X.123591  PMID:24369197
Background: A serious proportion of the patients with invasive cervical cancer can be women who have had abnormal smear findings known for at least 6 months. Aims: The aims of the study were to evaluate the cervical cytohistopathologic correlation in the population studied, and to discuss the acceptability of immediate histological verification for minor Papanicolaou smear abnormalities. Materials and Methods: A total of 443 patients who were admitted with abnormal smear results and had undergone immediate colposcopy, cervical biopsy and endocervical curretage in the gynecologic oncology clinic between the years of 2003-2009 were enrolled into the present retrospective study. One-way analysis of variance and independent t-tests were used to study the results. Results: The distribution of abnormal smear results were documented as 46.27%, 29.57%, 13.76%, 7.67%, 1.58%, 0.67%, and 0.45% for atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), squamous cell carcinoma (SCC), atypical glandular cell (AGC), and adenocarcinoma, respectively. The percentages of cervical intraepithelial neoplasia grade 2-3 (CIN 2-3) and greater lesions were 70.49%, 35.29%, 15.26%, and 9.75% for HSIL, ASC-H, LSIL, and ASC-US, respectively. Moreover, 38.36% of all the CIN 2-3 or cancer (n = 104) cases originated from those with low grade referral diagnosis (ASC-US and LSIL). Conclusions: The majority of cases in the study were predominantly ASC-US and LSIL and approximately 40% of all the high grade lesions came from those with low grade referral diagnosis. This shows poor cytohistopathological correlation and calls the triage of minor cytological abnormalities into question.
  2,856 2,077 1
Accuracy rate of frozen section studies in ovarian cancers: A regional cancer institute experience
A Subbian, UK Devi, UD Bafna
October-December 2013, 50(4):302-305
DOI:10.4103/0019-509X.123599  PMID:24369204
Background: Frozen section is a valuable diagnostic procedure in the categorization of ovarian tumors as benign, borderline and malignant. Thus, it guides in tailoring surgical therapy, particularly in young women. Aim: This study was undertaken to determine the accuracy of frozen section in ovarian neoplasms. Materials and Methods: A retrospective analysis was done of intraoperative frozen sections for suspected ovarian neoplasms. The frozen and permanent section reports were compared and overall accuracy, sensitivity, specificity, positive and negative predictive values were determined. Results: The study included 135 patients and the overall accuracy of frozen section in determining malignancy was 84.25%. Twenty cases were incorrectly diagnosed, of which 16 cases were under-diagnosed and four were over-diagnosed. With respect to malignant potential, the sensitivity for malignant tumors was highest (91.5%) with specificity of 98.2%. For benign tumors, the sensitivity and specificity were 90.4% and 82.6%, respectively. Borderline tumors had the lowest sensitivity of 31.2% with specificity of 94%. Sensitivity for benign, borderline and malignant tumors in the non-mucinous group was 91.3%, 60% and 95% respectively, whereas the sensitivity was 75%, 18% and 57%, respectively, for mucinous tumors revealing low sensitivity in borderline, mucinous tumors. The low sensitivity rates were due to restriction in the sampling of an adequate number of bits in the large sized tumors. Conclusion: The present study concurs that frozen section is an accurate test for diagnosis of benign and malignant tumors. However, accuracy rates for borderline and mucinous tumors are low.
  3,995 576 8
Five year retrospective survival analysis of triple negative breast cancer in North-West India
B Sharma, Satyanarayan , A Kalwar, N Sharma, A Kapoor, N Kumar
October-December 2013, 50(4):330-332
DOI:10.4103/0019-509X.123616  PMID:24369211
Background: In our institute, about 10% of total cancer is female breast cancer. This analysis was performed to check triple negativity among these patients with their survival strength up to 5 years in relation to different age groups, stage and chemotherapy protocols. Materials and Methods: 208 immunohistochemistry proved triple negative breast cancer patients registered and treated until 2008 were retrospectively selected for the study. Overall survival up to 5 years was observed on the basis of stage, different age groups and chemotherapy regimens. All patients had undergone surgery, conventional external beam radiation therapy and adjuvant chemotherapy. The survival analyses were performed using the Kaplan-Meier method. Results: The majority of patients (41%) were in the age group 21-30 years. Stage IV was seen in 18% of the patients at diagnosis and mainly in 21-40 years age group. Only 3% of females were >70 years age and were of Stage I and II. Overall 5 year survival in Stage I in Cyclophosphamide, Adriamycin/Epirubicin, 5-Flurouracil group was 37.5% as compared with Docetaxel/Paclitaxel, Epirubicin group 93% (P < 0.0001). Conclusion: Triple negativity in North-West India is about 11.8%. We observed it in younger patients mainly with highly aggressive behaviors. Taxane based chemotherapy gives better result as compared with anthracycline based regimens in all stages.
  3,972 503 5
Synchronous primary cancers of the head and neck region and upper aero digestive tract: Defining high-risk patients
M Krishnatreya, T Rahman, AC Kataki, A Das, AK Das, K Lahkar
October-December 2013, 50(4):322-326
DOI:10.4103/0019-509X.123610  PMID:24369209
Background: Patients with cancers in the head and region are at increased risk of developing synchronous primary cancers. Aim: To see the epidemiology of synchronous cancers of the head and region and identification of high-risk factors for the development of synchronous primary in the head and neck cancers. Materials and Methods: Data of head and neck cancer patients from January 2010 to December 2011 were obtained from the hospital cancer registry for retrospective analysis of patients with synchronous cancers. All synchronous malignancies were analyzed for distribution of sites, association with smoking history, stage of index head, and neck tumor and the average age of patients at presentation with synchronous cancers. The Chi-square test for association of upper aero digestive tract (UADT) and smoking and statistical formula of median for calculating the average age have been employed for analysis. Results: Incidence of synchronous primaries has been found to be 1.33%, majority were seen at the oropharynx (39.2%) and 60.7% synchronous occurred at the esophagus, 0.81% of all head and neck cancers developed synchronous primary at the esophagus. Approximately, 65% of all synchronous primaries were in Stage III and Stage IV disease and 88.2% esophageal synchronous had Stage II disease. Association of UADT synchronous cancers with smoking is highly significant, relative risk = 1.95 95% confidence interval for relative risk 1.05-3.64 P = 0.00010981 (P < 0.05) and the average age is 62.4 years in males and 57.8 years in females. Conclusion: Patients who are at the high-risk for the development of synchronous primary tumors in the cancers of the head and neck region are patients with oropharyngeal carcinoma, smoking population, patients over the age of 62 years in males, and 57 years in females and in patients with higher staged index tumor.
  3,778 433 6
Evaluation of clinico: Pathologic findings of breast carcinoma in a general hospital in Southern India
M Mohapatra, S Satyanarayana
October-December 2013, 50(4):297-301
DOI:10.4103/0019-509X.123594  PMID:24369200
Background and Objectives: Breast cancer is the second most common cancer in the Indian female population. As per our hospital data, breast cancer is also found to be the second leading malignancy in women. Hence, we undertook this study to evaluate the clinical profile, histopathologic types, grade, stage and the prognosis of the disease in our patients. Majority of our patients are from rural areas. Materials and Methods: This study was undertaken over a period of three years comprising of 178 patients who underwent modified radical mastectomy following preliminary diagnosis of carcinoma on fine needle aspiration cytology or histopathological examination of the lumpectomy or trucut biopsy specimens. Clinico-pathological evaluation was done in all of these cases following standard protocols. Result: The study comprised of 175 female patients and 3 male patients in the age range of 28 to 76 years. Majority (111/62.3%) of the cases were within the age range of 31-50 years of age with mean age of 48.7 years. Two females had bilateral breast cancer and one female had synchronous papillary serous cystadenocarcinoma of the ovary. Invasive ductal carcinoma no special type was the most common histopathologic pattern, and was seen in 172 (95.5%) cases. Most tumors were Scarff Bloom Richardson grade II and American Joint Committee on Cancer pathologic stage II. Prognostically, majority of tumors (49.5%) was assessed as 'good' as per the Nottingham prognostic index score. Conclusions: This study gave an insight to the clinico-pathological profile of breast cancer in our area. Long term study with follow up of the patient is needed for better understanding of the case.
  2,838 1,014 2
Challenges in management of phyllodes tumors of the breast: A retrospective analysis of 150 patients
P Ramakant, S Chakravarthy, JA Cherian, DT Abraham, MJ Paul
October-December 2013, 50(4):345-348
DOI:10.4103/0019-509X.123625  PMID:24369215
Introduction: Phyllodes tumors (PT) of the breast seem to get pre-operatively misdiagnosed as fibroadenomas resulting in inadequate resections and high local recurrence rates. Materials and Methods: Data of 150 patients with PT of the breast managed from January, 2003 to February, 2013 were retrospectively analyzed. Statistical analysis performed using SPSS version 17 (Pearson Chi-square test and analysis of variance test for analysis). Aim: The aim of this study is to compare clinico-pathological profile and recurrence rates in patients with benign (B), borderline malignant (BL) and malignant (M) PT. Results: In a total of 150 patients with PT (n = 77 B, n = 24 BL, n = 49 M), mean age was 36.92, 44.04 and 40.46 years respectively (P 0.015) and mean tumor size being 8.15 cm, 14.7 cm and 12.9 cm respectively (P 0.000). Pre-operatively cytology suggestive of PT in 24% patients with B PT and 63% in M PT; core tissue biopsy suggestive of PT in 85.4% patients with B PT and 100% in M PT. Recurrence seen in 34.7% out of which 32.7% were post-lumpectomy performed elsewhere. Majority of B PT had lumpectomy (49.3%)/wide local excision (WLE, 31.2%) compared with M PT where 55.1% had simple mastectomy (SM) due to large tumor size. Local recurrence was more in M PT (53%) compared with B PT (20%). We found recurrence rates in L (39.3%) compared with WLE (27.3%) and SM (33.9%) (P 0.049). Conclusions: Larger tumor size, incomplete resection and M/BL histology predicted higher recurrence in PT. Core biopsy is much more accurate than fine needle cytology in the diagnosis.
  3,175 504 11
Pre-operative contrast enhanced computer tomographic evaluation of cervical nodal metastatic disease in oral squamous cell carcinoma
P Pandeshwar, K Jayanthi, P Raghuram
October-December 2013, 50(4):310-315
DOI:10.4103/0019-509X.123605  PMID:24369206
Aims: This prospective study was undertaken to evaluate the contrast enhanced computed tomography (CECT) criteria in detecting cervical lymph node metastasis in 50 patients with an oral squamous cell carcinoma (OSQCC). Materials and Methods: A total of 50 patients with OSQCC who underwent clinical assessment, routine CECT scanning of cervical lymph node and radical neck dissection were analyzed. Radiologic criteria for diagnosing nodal metastasis in this imaging study were: A nodal size of 1 cm, the presence of central lucency despite the size of the lymph node and grouping of lymph nodes. These criteria were based on modified American Joint Committee on Cancer Radiological Nodal Staging Guidelines. Statistical Analysis: Chi-square test/Fisher Exact test has been used to find the significant association of findings. Diagnostic statistics viz.: Sensitivity, specificity, positive predictive value (PPV), negative predictive value, and diagnostic accuracy were obtained. The results were considered significant when P value was less than 0.05. Results: On using a nodal size of 1 cm and the presence of central nodal necrosis (CNN) as radiological criteria for nodal metastasis CT scanning staged 23 of the 27 histopathologically positive necks, providing accuracy of 88%, sensitivity of 92%, and specificity of 84% in detection of nodal metastasis. A significant relationship between the incidence of CNN, different nodal densities, and primary tumor differentiation was observed. Conclusions: The nodal size cut-off of 1-1.5 cm had a maximal sensitivity of 90.91% and PPV of 86.96%. Furthermore, observation of nodal densities in the absence of frank CNN on the CT scan may be necessary especially in low grade primary tumor. CT assessment of cervical node metastasis was found acceptable, although adjuncts like ultrasound guided fine needle aspiration may further increase efficacy of CT scan in nodes lesser than 1 cm in size.
  3,218 401 4
Is there a role of induction chemotherapy followed by resection in T4b oral cavity cancers?
A Joshi, VM Patil, V Noronha, S Juvekar, A Deshmukh, P Chatturvedi, DA Chaukar, JP Agarwal, S Ghosh, V Murthy, A D'cruz, K Prabhash
October-December 2013, 50(4):349-355
DOI:10.4103/0019-509X.123627  PMID:24369216
Objective: The objective of the following study is to investigate the efficacy and impact of induction chemotherapy in T4b oral cavity cancers. Materials and Methods: It's a retrospective analysis of prospectively collected data of T4b oral cavity cancer patients who were offered induction chemotherapy and then assessed for resectability at the end of 2 cycles of chemotherapy. Post-induction these patients either underwent surgical or non-surgical local intervention depending upon their response. These patients were then followed-up until either recurrence progression or death whichever was later. Statistical analysis was performed by SPSS version 16. Descriptive analysis was performed. Factors affecting achievement of resectability were sought by univariate and multivariate analysis. The impact of surgery on overall survival (OS) was studied using Kaplan Meier survival analysis with the use of log rank test. Results: A total of 110 patients received chemotherapy. Median age been 41.5 years (range 25-66 years). 21 (20%) of our patient received 3 drug regimen while the rest of our patients received 2 drug regimen. Partial response was achieved in 28 patients, stable disease in 49 patients and progression was noted in 23 patients. Resectability was achieved in 34 (30.9%) of 110 patients. The estimated median OS in patients who underwent surgery was 18.0 months (95% confidence interval [CI]: 13.6-22.46 months) and for those treated with non-surgical treatment was 6.5 months (95% CI: 5.6-7.4 months) (P = 0.0001). Conclusion: Use of induction chemotherapy is safe and can achieve resectability in 30.9% of our T4b patients. In those patients undergoing resection have much better OS then those who underwent non-surgical local treatment.
  2,894 540 7
Prevalence of ZAP-70 and CD 38 in Indian chronic lymphocytic leukemia patients
A Gogia, A Sharma, V Raina, L Kumar, R Gupta, R Kumar
October-December 2013, 50(4):333-336
DOI:10.4103/0019-509X.123620  PMID:24369212
Aim of Study: Chronic lymphocytic leukemia (CLL) is the most common chronic lympho-proliferative disorder. This study was undertaken to know the prevalence of ZAP-70 and CD 38 in the treatment naive patients of CLL seen at a tertiary care centre of north India. Materials and Methods: ZAP-70 and CD 38 were tested by flow cytometry on peripheral blood samples. ZAP-70 positive and CD 38 positivity was defined as positive expression on 20% and 30% of CLL cells, respectively. Clinico-hematological profile and its correlation with ZAP-70 and CD 38 were assessed in consecutive 80 CLL patients. Results: There were 64 males and median age of the group was 58 years. Sixteen patients (20%) were asymptomatic and diagnosed incidentally. Median total lymphocyte count (TLC) at presentation was 62 × 10 9 /L. Rai stage distribution was: Stage 0-6, stage I-20, stage II-36, stage III-5, and stage IV-13. ZAP-70 and CD 38 positivity were detected in 20 patients (25%) and 29 patients (36%), respectively. Eleven patients were positive and 34 were negative for both ZAP-70 and CD 38 yielding a concordance rate of 56%. There was no statistically significant difference between ZAP-70 and CD 38 positivity and negativity with regard to age, sex, Lymphocyte count, lymphadenopathy, organomegaly, and Rai staging. Conclusion: ZAP-70 and CD 38 positivity were detected 25% and 36%, respectively, with concordance rate of 56%, which is higher than Western literature. There was no correlation of ZAP-70 and CD 38 positivity with age, sex, lymphadenopathy, organomegaly, and Rai staging.
  2,925 379 4
Lung cancer epidemiology and clinical profile in North India: Similarities and differences with other geographical regions of India
N Singh, D Behera
October-December 2013, 50(4):291-291
DOI:10.4103/0019-509X.123581  PMID:24369196
  2,430 699 6
Enlarging nonossifying fibroma mimicking aggressive bone tumour
V Wadhwa, RS Thakkar, JA Carrino, A Chhabra
October-December 2013, 50(4):301-301
DOI:10.4103/0019-509X.123634  PMID:24369203
  2,847 256 -
Massive ascites as an presenting feature of plasma cell leukemia
A Gogia, V Raina, R Gupta
October-December 2013, 50(4):301-301
DOI:10.4103/0019-509X.123632  PMID:24369201
  2,294 446 -
Disseminated tuberculosis mimicking relapse in hairy cell leukemia
A Gogia, V Raina, R Gupta
October-December 2013, 50(4):321-321
DOI:10.4103/0019-509X.123608  PMID:24369208
  2,238 317 -
A clinicopathologic analysis of 88 lung resections of suspected metastatic carcinomas with proven primaries
K Kathuria, NA Jambhekar, CS Pramesh, K George, SS Desai
October-December 2013, 50(4):356-360
DOI:10.4103/0019-509X.123628  PMID:24369217
Background: The lung is the most common site for metastatic carcinomas. Very few studies have comprehensively analyzed all pulmonary resections for metastatic carcinomas. Aims and Objectives: To analyze all lung resections for suspected metastatic carcinomas accrued over 10 years to evaluate:
  1. The most frequent primary site,
  2. The interval between primary tumor diagnosis and lung metastases, and
  3. The proportion of inadvertently resected benign lesions, clinicoradiologically mistakenfor metastatic deposits.
Materials and Methods: Between 2002 and 2011, 88 pulmonary metastasectomies were done for suspected metastatic carcinomas, which form the basis of this study. Results: In 81 of 88 cases (92%) the diagnosis of metastatic carcinoma was histologically confirmed, whereas 7 cases (8%) were non-neoplastic. The mean interval between primary tumor and metastases was 2.5 years. The primary sites were colorectum (30; 37%), kidney and breast (14; 17.3% each), cervix (9; 10%), salivary gland carcinoma (3), thyroid carcinoma (2), squamous carcinoma (2, one each of mandible and larynx), papillary urothelial carcinoma (2), hepatocellular carcinoma (1), endometrioid adenocarcinoma (1), carcinosarcoma of endometrium (1), adrenocortical carcinoma (1), and neuroendocrine carcinoma (1). The 7 non-neoplastic lesions (8%) histologically revealed tuberculosis (4), bronchopneumonia (2), and aspergillosis (1). Conclusions: Almost three fourths (71.6%) of the metastatic pulmonary resections comprised primaries from colorectum, breast and kidney. The interval between primary tumor and metastases ranged from zero months to 10 years (mean 2.5 years). Tuberculosis was the most common histologic diagnosis among the 8% of the non-neoplastic lesions, which were mistaken for metastatic carcinoma on clinical evaluation.
  1,995 331 1
A comparison of results by sequential and concurrent chemo radiotherapy in locally advanced carcinoma esophagus
V Bhandari, KL Gupta, R Taran
October-December 2013, 50(4):341-344
DOI:10.4103/0019-509X.123624  PMID:24369214
Aim: Many Trials using sequential and concurrent chemo radiotherapy have been done so far and has established the role of concurrent chemo radiotherapy in treatment of inoperable carcinoma esophagus. In this study, we have compared the results of concurrent chemo radiotherapy with sequential chemo radiotherapy. We have treated inoperable carcinoma esophagus in both the settings and present here the comparison of results in the two settings. Materials and Methods: There were 26 patients of carcinoma esophagus in sequential and 31 in concurrent chemo radiotherapy arm. In sequential arm methotrexate and Cisplatin followed by radiotherapy was given whereas in concurrent arm, Cisplatin was given once weekly along with radiotherapy. Results: The 2 year survival was 38% in sequential and35.5% in the concurrent setting and the median survival was 19.5 and 18 months respectively in the two arms.The toxicities in both the arms were comparable. P value of 0.4774 with confidence interval of 95% was obtained, which is not significant. Dysphagia was improved earlier in sequential than in the concurrent arm. Conclusion: As the results and toxicities in both the arms are almost similar with better symptom control, so larger randomized trials are required to assess the response and the use of methotrexate in sequential chemo radiotherapy can be further explored.
  1,806 303 1
Cryptosporidial diarrhea in a patient of all-trans-retinoic-acid syndrome treated successfully with azithromycin
T Ghatak, S Samanta, AK Baronia
October-December 2013, 50(4):296-296
DOI:10.4103/0019-509X.123592  PMID:24369198
  1,637 278 1
Primary non-Hodgkin lymphoma of the bladder
RB Nerli, AK Guntaka, S Das, MB Hiremath
October-December 2013, 50(4):296-296
DOI:10.4103/0019-509X.123593  PMID:24369199
  1,542 282 -
Adrenal cortical carcinoma in Thailand: A review on the previous reported case
B Joob, V Wiwanitkit
October-December 2013, 50(4):327-329
DOI:10.4103/0019-509X.123611  PMID:24369210
Background: Adrenal cortical carcinoma (ACC) is an uncommon cancer. Materials and Methods: The author performed a literature review on the reports of ACC in Thailand in order to summarize the characteristics of this rare cancer among Thai patients. Results: According to this study, there have been at least seven reports in the literature of nine individual cases of ACC, of which none was lethal directly to ACC. Conclusions: Here, the ACC is sporadically reported in Thailand. The diagnosis of ACC is usually by detection adrenal mass using imaging technique and the confirmation for the nature of cancer is usually by histopathology. Nevertheless, among the Thai population, the prognostic outcome is usually good.
  1,569 235 -
Cryptococcal meningitis in chronic lymphocytic leukemia
A Gogia, P Mehta, V Raina
October-December 2013, 50(4):301-301
DOI:10.4103/0019-509X.123633  PMID:24369202
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