Vanita Kumar

Posterior reversible encephalopathy syndrome in non-Hodgkin′s lymphoma: Not necessarily reversible!

Posterior reversible encephalopathy syndrome (PRES) is a rare clinicoradiological entity that is an increasingly recognized complication of pediatric cancer treatment. However, there have been very few reports of PRES in association with non- Hodgkin′s lymphoma (NHL) and reported incidence is only 0.06%. The available literature and case reports on PRES were studied in depth, and the important conclusions were taken into account for writing athe review. We describe a case of PRES in a boy of 15 years with NHL on cyclophosphamide, doxorubicin, vincristine and prednisolone combination chemotherapy who presented with generalized seizures and reversible blindness. Magnetic resonance imaging of the brain revealed characteristic findings of the syndrome establishing the diagnosis. However, despite transient improvement of the symptoms, the patient succumbed to respiratory failure. The authors conclude that PRES is a rare entity especially in NHL patients that must be recognized early and should be managed aggressively as it may prove to be fatal also.

Malignant phyllodes tumor with chondro and osteosarcomatous differentiation and secondaries in lungs

Phyllodes tumor is a rare breast tumor, with neoplastic epithelial and stromal components for 10 cm in size and firm in consistency. She underwent left mastectomy. The histopathology revealed a malignant phyllodes tumor with sarcomatous stromal overgrowth and heterogeneous chondro and osteosarcomatous differentiation. At 2 months after surgery, she reported to us with secondaries in bilateral lungs. We planned palliative chemotherapy in view of good general condition of the patient and lung metastasis. Chemotherapy included ifosfamide, adriamycin and cisplatin as per standard regimen every 3 weekly. After three cycles, her lung metastasis cleared completely. It was planned to continue same chemotherapy for six cycles.

Cutaneous metastasis involving face in breast cancer: A series of three patients

Breast carcinoma is the most common malignancy encountered in clinical practice presenting with cutaneous metastasis (CM). CM all over the body with involvement of eyelids is very rare. Here, we present a case series of three patients, two with common nodular metastasis to facial skin and one, a rare case of carcinoma breast with multiple diffuse CM all over the body and face involving eyelids.

Histopathological evaluation of Skin Tumours

Introduction: The skin is the largest organ of the body. Skin tumours encompass a wide spectrum and belong to a diverse group of neoplasm rendering the classification difficult. Aim: The aim of our study was to analyse prospectively the distribution of skin tumours with reference to age and sex. Materials and methods: The present study was a prospective study of skin tumours from 1st January 2013 –31st August 2015 at Department of Pathology in Sardar Patel Medical College and associated group of hospitals, Bikaner. The study included all histopathologically confirmed cases of skin tumours. Results: Out of 110 skin tumours, 74 were benign tumours and 36 were malignant. Thus benign tumours were more common than malignant tumours with benign to malignant ratio of 2.05:1. Incidence of epidermal tumours was highest 83 cases (75.45%) followed by adnexal tumours 20 cases (18.18%). The maximum number of benign tumours was found in second and third decade and malignant tumours in seventh decade. Conclusion: Benign tumours were common in younger age group whereas malignant tumors showed an ascending trend in age. Both benign and malignant tumours of skin were common in males than females. Verrucas (31.08%) were the commonest benign tumours followed by squamous papilloma (14.86%). Among the malignant tumours Squamous Cell Carcinoma (SCC) was the commonest (55.55%) followed by Basal Cell Carcinoma (30.55%).

Microfilariae coexistent with the cytology of adenocarcinoma gall bladder: An unnoticed comorbidity

Lymphatic filariasis is endemic in 250 districts in 20 states and union territories of India. Microfilariae have been reported in body cavity fluids and cytological evaluation of various lesions including benign as well as malignant neoplasms. Here, we present a rare case of incidentally found microfilariae in a cytological smear from gallbladder adenocarcinoma. Along with supporting the cytology as an important tool in detection of asymptomatic filariasis, we wish to draw the attention toward a more dedicated approach to eliminate this disease entity and toward unnoticed comorbidities in carcinoma patients.

HMB-45 negative multifocal malignant perivascular epithelioid cell tumor of the soft tissue responding to sirolimus: First case report from India

Perivascular epithelioid cell tumor (PEComa) is a group of sarcomas that exhibit a myomelanocytic phenotype and possess a unique cell type in the perivascular epithelioid cell. Traditionally HMB-45 immunoreactivity is the first criteria required to consider a tumor to be PEComa. We report a case of multifocal PEComa with negative HMB-45 marker. The patient presented with three big ulceroproliferative lesions; two over right thigh and one over the scalp in the right frontal region. The patient was prescribed with oral sirolimus to which good response was seen. To the best of our knowledge, this is the first case of HMB-45 negative multifocal malignant PEComa from India.

Sociodemographic parameters of Esophageal Cancer in northwest India: A regional cancer center experience of 10 years

Background: Despite various advances in the treatment of Esophageal Cancer (EC), being one of the least responsive tumors to cancer therapy, the overall prognosis remains poor. Therefore, it is significant to understand various sociodemographic factors associated with EC to find out various schemes for primary prevention of the disease. Materials and Methods: This is a retrospective analysis of medical records of the EC patients registered in the regional cancer center of northwest India from January 2003 to December 2012. The site of the disease and the histology were also recorded in addition to the various sociodemographic parameters. Results: Out of 55,742 patients registered in our hospital; 3,667 were diagnosed to have EC. Male:female ratio was 1.15:1. The mean age was 54.6 ± 11.74 years; 66.15% of the patients were illiterate and 48.6% belonged to the low socioeconomic status. Smoking and alcohol consumption were identified as risk factors in 48 and 25.6% of the patients, respectively. Conclusions: The etiology in majority of the patients is linked to tobacco and alcohol, thus, modification of life style with limiting the use of addictions may be an effective strategy in the prevention of this dreaded and mostly incurable disease.

Myoepithelioma of parotid: A case report and review of literature

Myoepithelioma (ME) is a rarely encountered tumor of salivary gland accounting for about 1% of all salivary gland tumors. Though they were first identified long back, still their histopathologic features and immunohistochemistry (IHC) profile are not well characterized and there is no definitive criterion for this tumor with complex and varied features remaining a major barrier. We present a case of parotid enlargement in an 18-year-old girl in whom the IHC studies of superficial parotidectomy specimen revealed positive staining for Cytokeratin 5/6, HMW CK, Smooth muscle actin (SMA), S100, calponin, vimentin, and p63. CD45, EMA, CK7, carcinoembryonic antigen (CEA), BerEP4, GCDFP-15, and Glial fibrillary acidic protein (GFAP)-stained negative. With these IHC findings, the diagnosis of ME of parotid was established. This report highlights the importance of IHC studies along with a brief review of the literature.