N. Geetha

Endodermal sinus tumors in the head and neck region

Extragonadal germ cell tumors of the head and neck region account for only 5% of all benign and malignant germ cell tumors. Endodermal sinus tumors (EST) of the head and neck region are rare. We report three patients with EST of head and neck region over a period of 10 years; the primary sites of tumor were orbit, maxillofacial region and retroauricular region. Histopathological examination revealed malignant teratoma with predominant endodermal sinus pattern in two, and pure EST in one patient. Serum alpha fetoprotein (AFP) was elevated in all three patients. Two patients had initial surgery but did not receive adjuvant chemotherapy, as the parents refused it. Partial remission was achieved in the other patient who received chemotherapy (cisplatin, bleomycin and vinblastin) and the patient died of infection after four courses of chemotherapy.

Acute lymphoblastic leukemia occurring as a second malignancy : Report of a case and review of literature

Secondary leukemias occurring after the treatment of childhood malignancies are most often acute nonlymphoblastic leukemias. Only rarely do acute lymphoblastic leukemias (ALL) occur as second malignancies. An 18-year-old boy who developed ALL 4 years after Hodgkins disease is described and the literature on secondary ALL is reviewed.

Avascular Necrosis of the Femoral Head in Neuroblastoma: A Case Report

Avascular necrosis of bone is a well-described complication of cancer chemotherapy containing corticosteroids, and has been observed in lymphomas and acute lymphoblastic leukemia. Avascular necrosis occurring in association with neuroblastoma has never been reported before. This study reports on a 7-year-old boy with stage IV neuroblastoma developing avascular necrosis of the femoral head of both hips during treatment with combination chemotherapy using cyclophosphamide, cisplatin, etoposide, and doxorubicin. He was given conservative treatment in view of the progressive disease.

Clinical implications of cytogenetic classification in adult acute lymphoblastic leukaemia patients.

Cytogenetic analysis performed on pretreated unstimulated, bone marrow/peripheral blood samples of 46 adult patients with acute lymphoblastic leukaemia (ALL) showed sufficient metaphases in 39 patients and insufficient metaphases in 7 patients. G-banded karyotype analysis of these 39 patients revealed nonrandom clonal chromosome abnormalities in 31 patients and apparently normal karyotypes in 8 patients. Numerical abnormalities involving chromosome trisomies and structural abnormalities involving different types of chromosomal translocations and deletions were encountered in varying percentages. These patients were grouped into various cytogenetic subsets on the basis of their karyotype pattern and followed-up to evaluate their prognosis. Patients with apparently normal karyotypes showed good prognosis and those with 6q− showed intermediate prognosis. But all other patients with hyperdiploid, pseudodiploid and hypodiploid karyotypes were associated with poor prognosis. Cytogenetic classification of ALL patients is thus of clinical importance, as it helps the early identification of clinically important prognostic groups.

Late recurrence of childhood acute lymphoblastic leukemia.

Late relapse of childhood lymphoblastic leukemia 10 years after the end of treatment is rare. A young woman whose acute lymphoblastic leukemia recurred 11 years after the end of treatment for acute lymphoblastic leukemia is described, and the literature on late relapse of childhood acute lymphoblastic leukemia is reviewed.

Renal relapse in bilateral synchronous testicular lymphoma

Bilateral synchronous testicular lymphoma is an uncommon presentation of non-Hodgkins lymphoma. A young man with non-Hodgkins lymphoma of both testes synchronously is described here. He underwent bilateral orchiectomy, received chemotherapy, and was in complete remission when there was a relapse in the kidneys. Salvage chemotherapy was given. The patient developed progression of the residual lesion subsequently and was started on palliation with chlorambucil and prednisolone. He was alive at 34 months after diagnosis with disease.