Gurpreet Singh-Ranger

Capsular contraction following immediate reconstructive surgery for breast cancer – An association with methylene blue dye

Capsular contraction following implantation of breast prostheses occurs in 2–33% of patients undergoing breast augmentation. This condition can be debilitating for patients, and often requires revisional surgery. The aetiology of capsular contraction is unclear, but may be due to infection, haematoma or foreign body-type reactions.Methylene blue dye is a substance known to cause localised tissue inflammation, and is often used during breast cancer surgery to allow identification of the sentinel lymph node. We report a case of Baker Grade 4 capsular contraction necessitating revisional surgery, occurring in a patient who underwent immediate breast reconstruction during surgery for breast cancer. Methylene blue dye was used to locate the sentinel nodes during the original surgery, and was found to have heavily discoloured the prosthesis at subsequent revisional surgery. Capsular contraction may have been caused in part by a localised tissue reaction initiated by, or involving the dye.

Recurrence of granulosa cell tumour after thirty years with small bowel obstruction

Granulosa cell tumours of the ovary are rare, comprising around 3% of ovarian tumours. These tumours have preponderance for local spread and extremely late recurrence. Although previous cases of recurrence have been described, it is extremely unusual for these tumours to recur after thirty years. We describe a case of recurrence of granulosa cell tumour after 30 years, presenting as small bowel obstruction. The patient had not been followed up after the original surgery, and on histological analysis, recurrence of the original tumour was confirmed. This case report emphasises the necessity for lifelong follow-up of patients who have had these tumours excised, and also the unusual way in which these tumours can recur.

Welcome To International Seminars In Surgical Oncology

This editorial marks the launch of a new online journal for surgical and medical oncology. The internet has produced a profound shift in the way in which clinicians, researchers and patients seek, interpret and utilise medical information and research. The launch of our journal comes at a time when these changes are in a rapid phase of development and consolidation.

The American Joint Committee on Cancer staging (AJCC) Atlas, by Greene FL, Compton CC, Fritz AG, Shah JP, Winchester DP

This cancer staging atlas is an official publication of the American Joint Committee on Cancer, the worlds foremost authority on cancer staging information.

An unusual case of severe colitis after colonoscopy

Dear Sir, Colitis following endoscopy is extremely rare, and has only been described in patients with an underlying medical condition such as connective tissue disease1,2 or historically in cases of anaphylaxis to agents used to disinfect colonoscopes.3,4 This agent is no longer used in the cleaning cycle. We describe a case of colitis in an otherwise healthy young female after a straightforward colonoscopy. A 49 year old female attended our endoscopy department for a colonoscopy. Over the last few months, she had been complaining of symptoms of left sided abdominal discomfort and loose motions, with fatigue. There were no other symptoms of note, and her past medical history, family history and blood tests were unremarkable. She had been screened for connective tissue disease, and these tests were normal. Bowel preparation over the preceding 24 h with two sachets of Picolax (sodium picosulphate), was uneventful. She was cannulated …

Management of rectal cancer in the era of neoadjuvant chemoradiation

human factors, adverse events, and patient outcomes in surgery for pediatric cardiac disease. J. Thorac Cardiovasc. Surg. 2008; 136: 1422–8. 3. Pichert J, Miller C, Hollo A, Gauld-Jaeger J, Federspiel C, Hickson G. What health professionals can do to identify and resolve patient dissatisfaction. Jt. Comm. J. Qual. Improv. 1998; 24: 303–12. 4. Little P, Everitt H, Williamson I et al. Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. BMJ 2001; 323: 908–11. 5. White AA, Pichert JW, Bledsoe SH, Irwin C, Entman SS. Cause and effect analysis of closed claims in obstetrics and gynecology. Obstet. Gynecol. 2005; 105: 1031–8. 6. Anderson ID (ed.). Care of the Critically Ill Surgical Patient, 2nd edn. London: Hodder Arnold Publication, 2003. 7. O’Brien R, Dilley S, Cunningham N, van Dijk J, Vawser T, Paltridge D. Non-technical skills (NTS) in synthetic learning environments – mapping curricula for vocational specialist training, develop evidence, complete a needs analysis & pilot the curriculum. Final report to the Australian Society for Simulation in Healthcare.

Cyclooxygenease-2 and breast cancer

Recent research suggests that the cyclooxygenase-2 (COX-2), an isoenzyme of the COX enzyme system has a fundamental role in breast cancer pathogenesis and metastasis. COX-2 appears to be expressed by a large proportion of invasive breast cancers and by DCIS, and levels seem to correlate with those of angiogenic factors such as VEGF, and with tumour-promoting systems such as aromatase. This is particularly important when we consider that COX-2 is amenable to suppression by simple medications such as aspirin and selective COX-2 inhibitors. This chapter reviews the research exploring the role of COX-2 in breast cancer, and studies investigating COX-2 inhibition.