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  Citation statistics : Table of Contents
   2011| April-June  | Volume 7 | Issue 2  
    Online since July 12, 2011

 
 
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REVIEW ARTICLES
Human papilloma virus and oral infections: An update
KL Kumaraswamy, M Vidhya
April-June 2011, 7(2):120-127
DOI:10.4103/0973-1482.82915  
Human papilloma virus (HPV) is one of the most common virus groups affecting the skin and mucosal areas of the body in the world today. It is also a known fact that HPV causes many lesions in the oral cavity. The most common conditions induced by oral HPV infection are usually benign-like oral papillomas, oral condylomas, and focal epithelial hyperplasia. Oral HPV infection has been found to be associated with some cases of oropharyngeal cancer, but it is not the main risk factor for this kind of cancer. HPV is been proved to be the causative agent in causation of cervical cancers without doubt, but its role as a etiologic agent in causing oral cancers needs to be evaluated and studied more to come into any conclusion. We have used review papers, case reports, cohort studies, case control studies, and various internet sources published from 1960 to 2011 to prepare this review of literature.
  20 19,746 2,601
ORIGINAL ARTICLES
Osteopontin expression in nasopharyngeal carcinoma: Its relevance to the clinical stage of the disease
Hong-Han Wang, Xing-Wei Wang, Can-E Tang
April-June 2011, 7(2):138-142
DOI:10.4103/0973-1482.82926  
Purpose: To investigate osteopontin (OPN) expression in human nasopharyngeal carcinoma (NPC) and evaluate its clinical significance in the disease. Materials and Methods: The expression of OPN mRNA in 44 frozen NPC tissue and 15 normal nasopharyngeal epithelium tissue (NNET) samples was examined by semi-quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). OPN protein expression in 67 paraffin-embedded NPC tissue and 21 NNET samples was detected by immunohistochemistry (IHC). In addition, OPN expression was investigated in 12 paired NPC and para-carcinoma tissue (PCT) samples by western blotting (WB). The association between the expression of OPN and the clinicopathologic parameters of NPC was evaluated. Results: Three different methods all showed that the expression of OPN mRNA or protein in NPC was significantly higher than in NNET or PCT (P = 0.000, 0.001, 0.000, respectively). After an examination by IHC, 88.1% (59/67) of NPC samples showed strong or moderate positive OPN staining and 28.6% (6/21) of NNET samples displayed a weak positive OPN staining. The staining of OPN in tumor cells was mainly localized to the cytoplasm. OPN expression in NPC was not related to patient age or sex (P > 0.05), but was significantly related to tumor size, regional lymph nodal metastasis, and NPC clinical stages (P < 0.05). Conclusions: Our study demonstrated that OPN mRNA and protein overexpression in NPC may be important in the pathogenesis of the disease. It was strongly related to T stage, N stage and clinical stages of NPC, suggesting that OPN may be involved in NPC metastasis and progression.
  11 2,903 365
REVIEW ARTICLES
Role of positron emission tomography computed tomography in carcinoma lung evaluation
S Padma, P Shanmuga Sundaram, Shamily George
April-June 2011, 7(2):128-134
DOI:10.4103/0973-1482.82918  
Lung cancer has graduated from merely a reportable disease of 1912 to being the most common cause of cancer death in developed countries in recent years. The annual number of lung cancer deaths is greater than the combined cancer deaths from breast, colon and prostate. Its association with tobacco has been proved and is related to the type, amount of tobacco used, the age at initiation and duration of use. Significant advances have been made in the diagnosis and management of lung cancer over the past decade. The primary treatment of lung cancer is surgery and the best chance for a complete cure comes from the total resection of localized disease. Once nodal or distant metastases have developed, primary surgical intervention is ruled out and patient is considered for adjuvant chemotherapy with or without radiation therapy. Accurate staging and delineation of disease extent is therefore critical in the treatment planning of lung carcinoma patients. 18 F fluoro deoxy glucose (FDG) positron emission tomography (PET) has been proven to be a valuable noninvasive imaging modality in the evaluation of patients with known or suspected lung cancer and its integration with computed tomography (CT) has changed the face of PET imaging in many ways. This article will review the current role of FDG PET CT in the evaluation of pulmonary nodules, diagnosis, staging and restaging of non-small-cell lung carcinoma (NSCLC), role of PET in small cell lung Carcinoma (Ca), pleural disease and will also discuss its potential future applications.
  11 7,628 853
CASE REPORTS
Large cell neuroendocrine carcinoma of the endometrium: An extremely uncommon diagnosis, but worth the efforts
Kedar K Deodhar, RA Kerkar, Pallavi Suryawanshi, Hari Menon, Santosh Menon
April-June 2011, 7(2):211-213
DOI:10.4103/0973-1482.82942  
Neuroendocrine carcinomas (NEC) of the female genital tract are aggressive and uncommon tumors. They usually involve the cervix and ovary, and are seen very rarely in the endometrium. The overwhelming majority of endometrial NECs are of conventional small cell type (up to 60 cases). Only seven cases of large cell type NEC of the endometrium have been reported. We report a case of large-cell neuroendocrine carcinoma (LCNEC) of the endometrium in a 70-year-old female. The case is described for its rarity and shows that a high index of suspicion can help the pathologist to use immunohistochemistry and in turn help in selection of appropriate chemotherapy.
  7 6,530 556
REVIEW ARTICLES
Serum bone sialoprotein levels and bone metastases
Mario Uccello, Giulia Malaguarnera, Marco Vacante, Massimo Motta
April-June 2011, 7(2):115-119
DOI:10.4103/0973-1482.82912  
The skeleton is the most common site of tumor metastasis. The detection of metastatic bone disease is critical for primary cancer staging because it will condition the therapeutic decision and the prognosis. For the diagnosis of bone metastases, imaging techniques are usually employed, even if these techniques have some limitations in terms of accuracy and costs. An innovative, cheaper method for the screening of skeletal metastases could be the measurement of bone turnover markers. This article is aimed at providing a literature review on the clinical significance of increased serum levels of bone sialoprotein (BSP) observed in patients suffering from metastatic bone lesions. In addition, we have briefly summarized recent studies reporting the biological and pathological roles of BSP in bone remodeling and bone metastasis. Some studies have demonstrated that serum BSP can be considered as an early marker and a prognostic factor for the development of bone metastases. BSP may help in assessing osteolytic bone disease, in evaluating additional prognostic information and in monitoring treatment modalities.
  6 5,279 637
ORIGINAL ARTICLES
Dose variation during hypofractionated image-guided radiotherapy for prostate cancer: Planned versus delivered
Vedang Murthy, Pragya Shukla, Pranjal Adurkar, Zubin Master, Umesh Mahantshetty, Shyam K Shrivastava
April-June 2011, 7(2):162-167
DOI:10.4103/0973-1482.82920  
Aims: To determine variation in the actual doses delivered to the organs at risk and the target in patients treated for localized carcinoma of the prostate using image-guided radiotherapy. Materials and Methods: Ten patients treated with helical TomoTherapy underwent daily target localization with megavoltage CT, on which the prostate, rectum and bladder were recontoured. The planned adaptive module was used for dose recalculation. The study endpoints were to analyse the variations in certain dose-volume parameters of the rectum and bladder (BD 2cc , RD 2cc , BV 100% , BV 70% , RV 100% , RV 70% ), the maximum anteroposterior (AP) and lateral rectal diameters, the volume of the CTV receiving 100% of the prescription dose (CTV V 100% ) and the dose to 100% of the CTV (CTV D 100% ). Results: The difference between the planned and delivered target doses (CTV V100% and CTV D100%) was small and clinically insignificant indicating adequate target coverage during treatment. There was a large variation in the AP and lateral rectal diameters, with no particular trend or correlation to dose parameters being noted during the course of treatment. The mean AP diameter during treatment was significantly less than the planned diameter (P < 0.05). The percentage of fractions where the delivered BV100%, BV70%, RV100%, and RV70% was more than the planned values were 42.8%, 17.1%, 45.4%, and 44.4%, respectively. The delivered BD2cc and RD2cc were similar to their planned values. Conclusions: This study demonstrates the usefulness of daily soft tissue image guidance in negating the effects of physiological variation of the rectum and bladder on the dose delivered to the prostate.
  5 2,769 343
CASE REPORTS
Myxofibrosarcoma of the infratemporal space
Arvind Krishnamurthy, Anitha Vaidhyanathan, Urmila Majhi
April-June 2011, 7(2):185-188
DOI:10.4103/0973-1482.82913  
A 42-year-old lady described a three-month history of a left-sided, painless swelling below the left earlobe. She presented to us after an acute exacerbation - with complaints of aching pain over the area for the past ten days. Computed tomography (CT) revealed a heterodense mass lesion measuring 48 x 53 mm at its greatest dimension, arising from the left infratemporal fossa. A preoperative trucut biopsy of the lesion showed features of a spindle cell lesion with fibromyxoid stroma. Resection of the infratemporal mass, a left-sided posterior segmental mandibulectomy with infratemporal clearance was performed. The tumor was histopathologically and immunohistochemically diagnosed as a myxofibrosarcoma-Grade II. She received 56 Gy/30 fractions postoperatively. The patient's postoperative clinical course was uneventful, and she remains free of disease 26 months after treatment. We review our experience and to the best of our knowledge, document the first case of myxofibrosarcoma to arise in the infratemporal space.
  4 2,711 248
Axillary lymph node metastasis in papillary thyroid carcinoma: Report of a case and review of the literature
Arvind Krishnamurthy, Anitha Vaidhyanathan
April-June 2011, 7(2):220-222
DOI:10.4103/0973-1482.82936  
We report a case of axillary lymph node metastasis as a consequence of recurrent papillary thyroid carcinoma (PTC) in a 64-year-old lady. The patient initially presented in 2004 with a 10 × 10 cm size thyroid swelling of approximately 3-year duration and bilateral cervical lymphadenopathy. She underwent total thyroidectomy with bilateral neck dissection then. Pathological examination confirmed that the resected lesions were PTC and nodal metastases from thyroid. On follow-up over the next 6 years, she underwent excisions twice for cervical nodal recurrences. She presented to us in January 2010 with multiple right axillary adenopathy. Therapeutic right axillary dissection was done. Histopathologic examination revealed metastatic PTC with tall cell differentiation in 7 out of the 17 nodes. The patient is currently on thyroxine suppression therapy and remains disease free for the past 6 months. We review our experience and present a brief review of literature.
  4 9,938 458
ORIGINAL ARTICLES
A study on the tumor volume computation between different 3D treatment planning systems in radiotherapy
Ramachandran Prabhakar, Goura Kishor Rath, Kunhi Parambath Haresh, Nalliah Manoharan, Macherla Anjaneyulu Laviraj, Molaiyan Rajendran, Pramod Kumar Julka
April-June 2011, 7(2):168-173
DOI:10.4103/0973-1482.82917  
Background: Tumor volume plays a crucial role in the survival and local control of the patients treated with radiotherapy. The dose volume histogram also depends on the accuracy of the tumor delineation. Aims: The main aim is to study the variation observed in the computation of the target volume with different treatment planning systems and treatment sites. Materials and Methods: Sixty patients of different treatment sites which include brain, retinoblastoma, head and neck, lung, gall bladder, liver, anal canal etc, were selected for this study. The tumor volume was delineated on the Eclipse treatment planning systems and CT datasets and DICOM-RT structure sets were transferred to Pinnacle, Oncentra, Plato, Precise, Ergo++, and Tomocon contouring workstations. The recomputed volume from these planning systems was compared with the reference volume obtained from Eclipse. Similarly, the accuracy in generating PTV from CTV was also assessed with different planning systems for 5 and 10 mm. Statistical Analysis Used: SPSS 10.0 was used for analysis. Results: The overall comparison of the volume with different planning systems showed that Pinnacle calculated relatively larger volume followed by Plato as compared to Eclipse, whereas TOMOCON, Ergo ++, and Oncentra showed reduced volume. As far as the variation in CTV to PTV volume is concerned, pinnacle showed a relatively higher volume as compared to the Eclipse planning systems. Conclusion: The study shows that all the treatment planning systems showed variation in computing the tumor volume and the CTV to PTV generation also varied with the planning systems.
  4 8,220 575
The effect of a flavonoid fractions diosmin + hesperidin on radiation-induced acute proctitis in a rat model
Atakan Sezer, Ufuk Usta, Zafer Kocak, Mehmet Ali Yagci
April-June 2011, 7(2):152-156
DOI:10.4103/0973-1482.82927  
Background: To explore the protective effect of a flavonoid fractions diosmin + hesperidin (Daflon), against radiation-induced acute proctitis in an experimental rat model. Materials and Methods: Thirty four rats were divided into four groups. The rats in Group 1 received Daflon and underwent irradiation. The rats in Group 2 received no Daflon and underwent irradiation. The rats in Group 3 received Daflon and underwent sham irradiation. The rats in Group 4 received no Daflon and underwent sham irradiation. Daflon emulsion (100 mg/kg/day) was administered via an orogastric feeding tube to the rats in groups 1 and 3 starting from 1 day prior to irradiation until the euthanasia day (day 15 following irradiation). Radiation therapy was delivered on a cobalt-60 unit using a single fraction of 17.5 Gy defined at a depth of 1 cm through an anterior portal. Slides were examined by the same pathologist under a light microscope two times in a blinded manner. Results: When compared to group 2, the rats of Group 1 showed less glandular distortion and less mucosal inflammation with less infiltration of the crypt epithelia by the inflammatory cells (P < 0.001). A statistically significant increase in all parameters but muscular wall thickness was observed for the rats in Group 2 as compared to the group 3 and 4. Conclusions: Administration of a dose of 100 mg/kg/day of the diosmin + hesperidin resulted in decreased morphologic inflammatory changes. This drug may have protective effects against radiation-induced acute proctitis.
  4 5,092 573
CASE REPORTS
Urachal papillary cystadenocarcinoma: A rare case report
Kavita Mardi, Neelam Gupta
April-June 2011, 7(2):223-225
DOI:10.4103/0973-1482.82934  
Urachal papillary mucinous cystadenocarcinoma is a rare tumor and represents 0.17-0.34% of all bladder tumors. It has an insidious course and variable clinical presentation. We present a case report of a 37-year-old female who presented with a lump in the abdomen. MRI revealed a solidcystic mass in the right lumbar region. Fine needle aspiration cytology was suggestive of adenocarcinoma. Histopathological examination of the excised mass revealed papillary adenocarcinoma that brought out the presence of focal PAS-positive intracytoplasmic mucin in the tumor cells. Clinicians should have a high degree of suspicion for these rare tumors.
  3 2,559 236
Severe lactic acidosis in a patient with metastatic prostate cancer
Javier Munoz, Mohd Khushman , Amr Hanbali , Michael Stoltenberg
April-June 2011, 7(2):201-202
DOI:10.4103/0973-1482.82925  
Lactic acidosis (LA) due to malignancy was first reported in patients with acute leukemia. Since then, several malignancies have been reported to be associated with LA. The pathophysiology of cancer-related LA is multifactorial and still poorly understood. In general, chemotherapy is the only effective mean of correcting malignancy-related LA by cytoreduction of the tumor cells while at the same time decreasing malignant liver involvement leading to improved clearance of lactic acid. LA is rare in patients with malignancies and is usually associated with high mortality because of advanced disease process and high tumor burden. Increased awareness of this complication in certain malignancies is important because early initiation of chemotherapy may decrease LA and perhaps prolong survival. To our knowledge, this is the first case of otherwise unexplained severe LA in a patient with chemotherapy-refractory metastatic prostate cancer.
  3 7,489 334
High-grade plasmablastic neoplasm of humerus in an HIV-negative patient, which was indeterminate between plasmablastic lymphoma and plasmablastic myeloma
Santosh Kumar Mondal, Himel Bera, Pranab Kumar Biswas, Mamata Guha Mallick
April-June 2011, 7(2):214-216
DOI:10.4103/0973-1482.82943  
Plasmablastic lymphoma (PBL) of bone is a rare neoplasm that shares many confusing cytomorphological and immunohistochemical features with plasmablastic plasma cell myeloma (PBPCM). A 47-year-old female patient presented with a bony swelling and bone pain in the left humerus for the last 6 months. On radiological examination (x-ray and computed tomography) it appeared to be a lytic lesion, and a pathological fracture was detected. The patient was HIV-negative. Fine needle aspiration (FNA) was done from the lesion, which was inconclusive. Subsequently, incisional biopsy was taken. Histopathological examination and immunohistochemistry confirmed a high-grade plasmablastic neoplasm, favoring a diagnosis of PBL. Most of the reported cases of PBL have occurred in HIV-positive patients, and the bone is a very rare site. PBL can be confused with PBPCM. A final diagnosis should be rendered only after thorough histopathological and immunohistochemical examination.
  3 3,630 388
Giant cell tumor of the first metatarsal
Yasir Salam Siddiqui, M Zahid, Aamir Bin Sabir, Julfiqar
April-June 2011, 7(2):208-210
DOI:10.4103/0973-1482.82938  
Giant cell tumor (GCT) is a benign locally aggressive tumor with a tendency for local recurrence. GCT of metatarsal is of rare occurrence with very few cases reported so far. GCT in this location is rare and should be considered in the differential diagnosis of a destructive bony lesion in both skeletally immature and mature patients. We report the case of GCT of 1 st metatarsal in a 28-year-old female and discuss the difficult aspects of diagnosis.
  3 7,261 268
LETTERS TO THE EDITOR
Solitary anterior abdominal wall metastasis from osteogenic sarcoma of fibula as detected by FDG-PET imaging
Sandip Basu, Sangeeta B Desai
April-June 2011, 7(2):229-230
DOI:10.4103/0973-1482.82935  
  3 1,529 178
ORIGINAL ARTICLES
Esophageal cancer: 5-year survival rate at south-east of Caspian sea of northern Iran
Mohammad Hussin Taziki, Siamak Rajaee, Naser Behnampour, Massoud Tadrisee, Azad Reza Mansourian
April-June 2011, 7(2):135-137
DOI:10.4103/0973-1482.82923  
Background: Locating at southern margin of Caspian sea and Asian esophagus cancer cordon Golestan state is one of the most common sites of this cancer. Objective: This study designed to evaluate the 5-years survival rate of esophagus cancer. Materials and Methods: 55 patients with esophagus cancer diagnosed by pathologic examination, age, gender, type of tumor, clinical manifestation on the time of tumor metastases, treatment and patient survival time studied. The collecting data were analyzed by SPSS 11.5, and life table and Kaplan Meier methods were applied. Results: 55 patients studied included 11 females and 44 males respectively with average survival life time of 12.8 months for the 5-year survival rate for patients diagnosed at early stage was 0.025, patients with systemic symptoms such as weight loss was 0.00. Far metastases adverse effect on highest survivals was observed among patients who underwent surgery; the survival rate for such patients was about 0.014. Conclusions: Esophageal cancer is high in southern margin of Caspian Sea, it is suggested to design studies to find the probable risk factors and the screening tests for on-time diagnosis.
  3 2,780 335
CASE REPORTS
Multiple cutaneous malignancies in a patient of xeroderma pigmentosum
Vandana U Grampurohit, US Dinesh, Ravikala Rao
April-June 2011, 7(2):205-207
DOI:10.4103/0973-1482.82932  
Xeroderma pigmentosum is a genodermatosis characterized by photosensitivity and the development of cutaneous and internal malignancies at an early age. The basic defect underlying the clinical manifestations is a nucleotide excision repair defect, leading to defective repair of DNA damaged by ultraviolet radiation. These patients exhibit enhanced sensitivity to ionizing radiation. Patients with xeroderma pigmentosum who are younger than 20 years of age have a greater than 1000-fold increased risk of developing skin cancer. Early detection of these malignancies is necessary because they are fast growing, metastasize early and lead to death. Although, early detection and treatment of cutaneous malignancies will reduce the morbidity and mortality, genetic counseling remains the most important measure for preventing xeroderma pigmentosum. We report a case of xeroderma pigmentosum in an 18-year-old male presenting with multiple cutaneous malignancies: squamous cell carcinoma, malignant melanoma and pigmented basal cell carcinoma.
  2 4,218 423
ORIGINAL ARTICLES
Treatment results of high dose rate interstitial brachytherapy in carcinoma of eye lid
Surendra Azad, Vivek Choudhary
April-June 2011, 7(2):157-161
DOI:10.4103/0973-1482.82922  
Aim: The aim of this study was to evaluate the response of high dose rate interstitial brachytherapy in carcinoma eye lid. Materials and Methods: From January 2004 to December 2008, 20 diagnosed cases of carcinoma eye lid were reported in our department. Lower eye lid was involved in 11 patients and upper eye lid in 9 patients. All cases were staged clinically according to the TNM staging system. All patients were treated with high dose rate interstitial implant and analyzed for presence of residual disease, local recurrence, distant metastasis, radiation reaction and disease free survival. Results: There was 18 (90%) and 2 (10%) patients in stage I and II, respectively. Histological 10 (50%) cases were of squamous cell carcinoma, 8 (40%) cases were of sebaceous carcinoma and 2 (10%) cases were of basal cell carcinoma. All patients received six fraction of 6.5 Gy in 6 days. Complete response was seen in all patients. The median follow up time for all patients was 39.5 months with 95% confidence interval of 30.1 to 62.6 month. The 5-year disease free survival rate was 90%, 57.14%, and 50% for squamous cell carcinoma, sebaceous cell carcinoma and basal cell carcinoma, respectively. No isolated regional lymph node metastasis and distant metastases were seen. No visual complication was seen. Discussion: The results of this study suggest that high dose rate interstitial brachytherapy was appropriate for the treatment of early staged carcinoma of eye lid.
  2 4,506 515
Quantitative evaluation of serum fucose in oral squamous cell carcinoma patients
Rajkumar N Parwani, Simran R Parwani
April-June 2011, 7(2):143-147
DOI:10.4103/0973-1482.82928  
Background: Cancer, a disorder of cellular behavior is characterized by the alteration of serum glycoproteins, which are composed of different monosaccharides. One of the monosaccharides is l-fucose, a methyl pentose, which is the terminal sugar in most of the plasma glycoproteins. Elevated levels of protein-bound fucose have been reported in various disease states as well as in malignancies. Aim: To ascertain the role of serum fucose as a biomarker and to correlate with other studies for its effective clinical application. Materials and Method: T0 he study was carried out on 67 subjects, including 14 healthy individuals and 53 oral squamous cell carcinoma cases. The serum fucose level estimation was done based on the method as adopted by Winzler using cysteine reagent. Statistical analysis included Chi-square test, Karl Pearson correlation test and Student's t test to evaluate the significance and variability of values between groups. Results: Serum fucose levels were independent of age and sex. However, there was significant increase in mean serum fucose level of oral squamous cell carcinoma patients compared with healthy controls. The results correlated well with other studies. Conclusion: Serum fucose can be used as an effective diagnostic biomarker in oral squamous cell carcinoma patients.
  2 4,013 398
Computerized tomography-guided percutaneous high-dose-rate interstitial brachytherapy for malignant lung lesions
Daya Nand Sharma, Goura Kisor Rath, Sanjay Thulkar, Amit Bahl, Subhash Pandit, Parmod Kumar Julka
April-June 2011, 7(2):174-179
DOI:10.4103/0973-1482.82914  
Purpose: To study the feasibility of computerized tomography (CT)-guided percutaneous high-dose-rate interstitial brachytherapy (HDRIBT) in patients with malignant lung lesions (MLL), not suitable for surgery. Materials and Methods: From June 2007 to December 2008, eight patients with MLL (primary lung carcinoma, two; solitary lung metastases, six); were enrolled in this prospective trial. All patients had either refused surgery or had been found ineligible due to comorbidities. Under CT guidance, a single stainless steel needle for lesions up to 4 cm and two needles for lesions up to 6 cm in diameter were inserted percutaneously through the intercostal space. A single dose of 20 Gy with HDRIBT was prescribed at the periphery of the lesion. The needles were removed immediately after treatment. The endpoints of the study were acute perioperative complications like pneumothorax, hemothorax, hemoptysis, and so on, and short term (six-month) tumor control. Results: There were six males and two females with a median age of 55 years. The lesion size ranged from 3.0 - 5.5 cm (median 4.0 cm). The average time taken for the interstitial brachytherapy (IBT) procedure was 50 minutes. None of the patients had fatal complications. Two patients had minor complications (one hemoptysis and one minimal pleural effusion). Six of the eight patients had more than 50% reduction in the tumor dimensions at the end of six months. Conclusions: CT-guided HDRIBT is a safe and feasible non-surgical treatment option for patients with MLL. It provides effective tumor control and needs to be studied further.
  2 4,077 303
BRIEF COMMUNICATION
Renal cell carcinoma and hepatitis C virus infection: Is there any cause-outcome relationship?
Viroj Wiwanitkit
April-June 2011, 7(2):226-227
DOI:10.4103/0973-1482.82931  
Background: Hepatitis C virus is a common virus affecting human health. High rates of hepatitis C virus infection can be seen in many developing countries. It is accepted that hepatitis C virus is an oncogenic virus that can lead to liver cancer. Some recent researches also mentioned the possibility of hepatitis C virus as a risk for renal cell carcinoma. Aims: In this article, the author assesses the cause-outcome relationship between hepatitis C virus infection and renal cell carcinoma using the bioinformatics network analysis technique. Materials and Methods: The author firstly tracked for the hepatitis C virus related protein and renal cell carcinoma related protein and further detected the common protein. Further, tracing of the biological process using ontology study of the identified proteins was done and finalized network of relationship was derived. Statistical Analysis Used: Bioinformatics technique. Results and Conclusions: According to this study, there is only one common protein. Based on this work, it can be concluded that there might be cause-outcome relationship between hepatitis C virus infection and renal cell carcinoma via NY-REN-54. The process might be through the disturbance of autophagic response due to ubiquitin-protein ligase-related mechanism.
  1 2,208 259
CASE REPORTS
Radiation-induced sarcoma in bronchial stump after thoracic radiation therapy for small-cell lung cancer
Hong Zhu, XiaoGe Zhou, ChangSheng Wang
April-June 2011, 7(2):198-200
DOI:10.4103/0973-1482.82924  
We report a rare case of radiation-induced sarcoma (RIS) that arose in the right bronchial stump, 8 years after right pneumonectomy followed by adjuvant chemotherapy and thoracic radiotherapy for a localized small-cell lung cancer. The patient was treated in 2002 with 6 MV X-ray irradiation in a total dose of 60 Gy. Eight years after the end of radiotherapy, he presented with an undifferentiated high-grade pleomorphic sarcoma. Although an increased rate of soft tissue sarcoma has been reported after radiotherapy for some solid cancers or lymphomas, to our knowledge, this is the first report of RIS related to small-cell lung cancer.
  1 2,486 227
Squamous cell carcinoma cervix with metastasis to pyloroduodenal region
Jomon C Raphael, Thomas Samuel Ram, Simon Pavamani, Lisa Choudharie, PN Viswanathan
April-June 2011, 7(2):183-184
DOI:10.4103/0973-1482.82910  
Metastatic squamous cell carcinoma in the pyloroduodenal region is uncommon. Cases have been reported where carcinoma of the lung has presented with metastasis to the duodenum. We present here the case of a 57-year-old lady who was found to have a metastasis in pyloroduodenal region while on treatment for carcinoma cervix. The patient developed features of intestinal obstruction and endoscopy showed a growth extending from pyloric antrum to first part of duodenum up to the junction of first and second part. A biopsy was taken from the duodenal area and it was reported as metastatic squamous cell carcinoma. This is one of the few reported cases of hematogenous visceral metastasis from carcinoma cervix. Since the disease was found to be advanced and her performance status was poor, she was provided best supportive care.
  1 2,348 279
Cytology of hyalinising trabecular adenoma-like variant of medullary thyroid carcinoma
KV Santosh, Sujata Raychaudhuri, H Subramanya, BJ Naveen Kumar
April-June 2011, 7(2):189-191
DOI:10.4103/0973-1482.82916  
Medullary thyroid carcinoma is a rare thyroid neoplasm that can be either sporadic or familial. It occurs in adults, presenting as a solitary cold nodule on thyroid scan. Most are solid, firm, and non-encapsulated, and occur in the mid portion or upper half of the thyroid gland, corresponding to areas with greater numbers of C cells. We present a case of a 36-year-old female with a swelling in the front of her neck for six years. Fine needle aspiration done elsewhere revealed spindle cells, suggestive of a 'spindle cell neoplasm'. The histopathology of the thyroidectomy specimen showed features of a hyalinizing trabecular adenoma-like variant of medullary carcinoma. Subsequently, we performed aspiration on the received specimen and studied the cytological findings. The cytological diagnosis of this variant requires identification of the dual spindle and ovoid cell population and the granular neuroendocrine chromatin.
  1 4,600 242
EDITORIAL
Chernobyl, Fukushima, and beyond: A health safety perspective
Rajiv Sarin
April-June 2011, 7(2):109-111
DOI:10.4103/0973-1482.82908  
  1 5,219 811
LETTERS TO THE EDITOR
Intense FDG uptake in the spleen due to recent granulocyte-macrophage colony-stimulating factor administration: Follow-up scan clarifying the situation
Sandip Basu, Nawab S Baghel
April-June 2011, 7(2):228-229
DOI:10.4103/0973-1482.82933  
  1 2,639 191
FDG avid "abdominal band" representing omental cake in mucinous adenocarcinoma of the appendix: Potential implications for disease monitoring with FDG-PET in this setting
Sandip Basu, Tanuja Shet
April-June 2011, 7(2):231-233
DOI:10.4103/0973-1482.82939  
  1 2,850 183
ORIGINAL ARTICLES
Endobronchial ultrasound in hilar and conventional TBNA-negative/inconclusive mediastinal lymphadenopathy
Prashant N Chhajed, Rahel Odermatt, Christophe von Garnier, Parag Chaudhari, Joerg D Leuppi, Daiana Stolz, Michael Tamm
April-June 2011, 7(2):148-151
DOI:10.4103/0973-1482.82930  
Objective: Assess the diagnostic yield of real-time bronchoscopic ultrasound transbronchial needle aspiration (EBUS TBNA) in conventional TBNA-negative mediastinal lymphadenopathy and hilar lymphadenopathy. Materials and Methods: Sixty-two patients having either conventional TBNA-negative mediastinal lymphadenopathy or hilar lymphadenopathy underwent real-time EBUS TBNA. Results: EBUS TBNA was performed on 72 lymph nodes (mediastinal = 48; and hilar = 24). 31 of the 72 (43%) lymph node samples were positive for malignancy (29) or benign diagnosis (2), and 17 of the 72 (24%) lymph nodes were true negative at EBUS TBNA confirmed at surgery. Out of 48 mediastinal lymph nodes EBUS TBNA was diagnostic for malignancy in 19 (40%) and negative in 14 of which 12 (86%) were surgically confirmed true negative and 2 (14%) false negative. In 10 of the 24 (42%) hilar lymph nodes, EBUS TBNA was diagnostic for malignancy while 5 were true negative and 1 false negative. All false-negative lymph nodes were PET positive. Adequacy of EBUS TBNA based on positive aspiration and surgically confirmed true negative was 67% and in patients suspected for malignancy was 77%. Conclusions: EBUS TBNA has a good diagnostic yield in hilar lymphadenopathy and in conventional TBNA-negative mediastinal lymphadenopathy.
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BOOK REVIEW
Neurological Disorders in Famous Artists - Part 1, 2 & 3
Varsha Dutta
April-June 2011, 7(2):240-246
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CASE REPORTS
A fatal case of mesenchymal chondrosarcoma of the mandible
Arvind Krishnamurthy, Anitha Vaidhyanathan, Satish Srinivas, Urmila Majhi
April-June 2011, 7(2):192-194
DOI:10.4103/0973-1482.82919  
A 34-year-old man presented with an expansile, erosive tumor involving the left side of the mandible, with secondary invasion into the maxilla, measuring 13 Χ 7 cm. Microscopic analysis revealed a malignant small round cell neoplasm with focal cartilaginous differentiation. Immunohistochemical analysis revealed positivity for vimentin, NSE and CD99 with primitive small round cells, and S100 positivity with neoplastic chondrocytes. To the best of our knowledge, this is perhaps the largest reported case of mesenchymal chondrosarcoma of the maxillofacial region. Diagnosed as inoperable, he was treated with radiation and chemotherapy only to die within a few months.
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Metastasis of greater wing of sphenoid bone in bronchogenic carcinoma: A unusual case report
Prashant K Gupta, Mukta Mital, Amit Dwivedi, Kumkum Gupta
April-June 2011, 7(2):195-197
DOI:10.4103/0973-1482.82921  
Orbital metastasis in systemic cancer is known to occur and occurs in up to 7% of all systemic cancers. Orbital features typically present after the diagnosis of the primary tumor. In about 20% of cases, there is no known primary cancer at the time of presentation with orbital metastatic disease. Here we report a case of a 60-year-old male smoker, in whom proptosis, due to metastasis in greater wing of left sphenoid bone secondary to bronchogenic carcinoma, was the initial symptom. We could not find in literature metastasis to greater wing of sphenoid bone due to small cell carcinoma of lung.
  - 3,802 187
Metastatic medulloblastoma at diagnosis
Seema Gupta, MC Pant, N Husain, S Sundar
April-June 2011, 7(2):203-204
DOI:10.4103/0973-1482.82929  
Medulloblastoma is an aggressive tumor of the brain. It is the most common and the most malignant embryonal tumor of the pediatric central nervous system and a rare tumor of adults. We are reporting a rare presentation of adult classic subtype of medulloblastoma which was central in location with metastases in the suprasellar region at the time of diagnosis.
  - 2,524 259
Cutaneous metastasis of transitional cell bladder carcinoma: A rare presentation and literature review
Nikolaos S Salemis, Christos Gakis, Andreas Zografidis, Stavros Gourgiotis
April-June 2011, 7(2):217-219
DOI:10.4103/0973-1482.82940  
Cutaneous metastasis from transitional cell bladder carcinoma is a rare clinical entity associated with poor prognosis. We present a case of cutaneous metastasis arising from a transitional cell bladder carcinoma in a male patient who had undergone a radical cystectomy and bilateral ureterostomy 17 months previously. The cutaneous metastasis became evident 3 months before the manifestations of generalized recurrent disease. An awareness of this rare clinical entity and high index of suspicion is needed to rule out metastatic spread in patients with a previous history of transitional cell bladder carcinoma presenting with cutaneous nodules. Definitive diagnosis requires a histological confirmation, but prognosis is generally poor.
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INTERVIEW
Conversation with Dr. G. K. Rath
GK Rath, Sapna Gupta
April-June 2011, 7(2):235-236
  - 3,331 233
Conversation with Dr. K. A. Dinshaw
KA Dinshaw
April-June 2011, 7(2):237-239
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INVITED EDITORIAL
The paradox of attending to the self in brain tumor
Varsha Dutta
April-June 2011, 7(2):112-114
DOI:10.4103/0973-1482.82909  
  - 2,253 395
LETTERS TO THE EDITOR
In response to article by Dayanand et al.
Manoj Sharma
April-June 2011, 7(2):233-234
DOI:10.4103/0973-1482.82941  
  - 1,688 180
Long-term survival after resection of a lung cancer metastasis
George Fotakopoulos, George A Alexiou, Ann Goussia, Spyridon Voulgaris
April-June 2011, 7(2):230-231
DOI:10.4103/0973-1482.82937  
  - 1,765 219
ORIGINAL ARTICLES
Serum phosphodiesterase levels in oral cancer
K Prabhu, D Naik, S Ray, BM Vadiraja, A Kamath
April-June 2011, 7(2):180-182
DOI:10.4103/0973-1482.82911  
Background: Oral squamous cell carcinoma (OSCC) is one of the most common malignancies recognized nowadays. Its early detection is the better alternative to provide a good quality of life for the patients. During the last years, several studies have identified potential biomarkers of OSCC progression and prognosis. The phosphodiesterases (PDEs) are responsible for the hydrolysis of the second messengers with a fundamental role in the transduction of the intracellular signals. Variations in PDE activity have been correlated to different pathological mechanisms, such as cellular differentiation, apoptosis, and tumor invasivity. PDEs are also known to play a role in tumor growth by influencing angiogenesis. Aim: To estimate and compare serum PDE levels in healthy controls and biopsy-proven oral cancer patients before definitive therapy. Materials and Methods: Institutional Ethics Committee gave us the permission to conduct this study. After obtaining consent from biopsy-proven oral cancer patients (n = 39) (before onset of any definitive treatment) and age- and sex-matched healthy controls (n = 20), 2 ml of blood was collected in plain vacutainers. After clot formation, samples were centrifuged and serum was collected for estimation of PDE. Statistical Analysis: Kruskal-Wallis test; Mann-Whitney Test Results and Discussion: Pretreatment PDE levels were significantly elevated in oral cancer patients (P<0.0001) as compared with the controls and also there was a significant increase in PDE levels (P<0.001) with advancing stage in oral cancer patients. This may implicate a role for serum PDE in pathophysiology of oral cancer.
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