Arun Kumar Rathi

Management of chronic hemorrhagic radiation proctitis

Rectal bleeding secondary to radiation proctitis is the most dreaded complication of pelvic radiotherapy. Its management remains a perplexing problem despite the availability of multiple treatment modalities. Patients are usually managed on a “hit and miss” basis at most centers. Steroid, 5‐aminosalicylic acid, short chain fatty acids and sucralfate enemas, hyperbaric oxygen therapy, and topical application of 4% formaldehyde all have been used with varying results. Surgical procedures such diversion colostomy or resection of involved segment have been proposed for refractory bleeding. Endoscopic methods are being increasingly adopted in the form of bipolar electrocoagulation, heat probe coagulation, photoablation, Nd:YAG laser and preferably argon plasma coagulation. The utility of conservative approaches remains far below desirable levels. Onset of hemorrhagic recurrence represents a major obstacle that leads to a need for repeated therapeutic sessions and sometimes invocation of radical techniques. This review discusses various treatment modalities and aims to identify their efficacy and limitations. A critical review was conducted of published reports regarding management of chronic hemorrhagic radiation proctitis (CHRP). Although there are few prospective randomized trials, enough evidence is available to conclude that argon plasma coagulation represents the current treatment of choice.

Rationale, indications, techniques and applications of interstitial brachytherapy for carcinoma cervix

With evolution of different newer radiotherapy techniques, still the role of brachytherapy in different gynecological malignancies has not sublimed. Most commonly used form of brachytherapy in carcinoma cervix patients is intracavitary brachytherapy. However, all the patients do not qualify for the treatment with intracavitary brachytherapy due to certain clinicopathological conditions. This warrants use of interstitial brachytherapy technique for treatment. For getting good results from interstitial brachytherapy, a good expertise and a proper infrastructure are needed. For perineal interstitial brachytherapy, different templates have been designed, used, and published by authors in different literature over the period. Among all these different templates, Martinez Universal Perineal Interstitial Template (MUPIT) has been used in gynecological, urological, and anorectal malignancies. In this literature review, we have discussed mainly MUPIT.

Osteosarcoma with cutaneous-metastases : A case report

BACKGROUND Osteosarcomas, despite their aggressive nature and propensity to metastasize, only rarely give rise to skin deposits. CASE We report a case of a femoral osteosarcoma in which cutaneous scalp and neck metastases developed 3 years after treatment of the primary disease. Fine needle aspiration was pivotal in diagnosing the secondary disease. CONCLUSION Only 8 instances of cutaneous metastases from an osteosarcoma have been previously reported. We recommend early investigation of such nodules with fine needle aspiration cytology and inclusion of multiagent chemotherapy as part of the treatment protocol in all patients with osteosarcoma.

Mucinous breast carcinoma metastatic to parotid gland: report of a case diagnosed by fine-needle aspiration

Metastasis to the parotid gland from breast cancer(BC) is extremely rare. A 37 year old female with a previous history of breast carcinoma presented with right cheek mass underwent fine needle aspiration cytology (FNAC) which revealed numerous epithelial cells showing moderate pleomorphism with presence of intracytoplasmic mucin which created a cytological dilemma to differentiate from primary mucin secreting adenocarcinoma. This article is protected by copyright. All rights reserved.

Gynecomastia: A review of literature

Gynecomastia is a benign enlargement of the male breast tissue, either due to the proliferation of glandular tissue or deposition of fat in breast tissue, usually caused by imbalance of estrogen and androgen hormones in body. Gynecomastia has a trimodal age distribution and begins as a small lump beneath the nipple which may be tender. Gynecomastia is usually benign but may be a cause of embarrassment for some. Evaluation of gynecomastia is performed with an aim at diagnosing the cause for the same. Individual treatment requirements can range from simple reassurance to medical treatment or even surgery depending on the etiology.