Journal of Cancer and Allied Specialties
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Mucinous carcinoma of breast: A rare tumour with favorable prognosis - 10 years experience from a single center
Full text linkPurpose: The purpose of this study was to describe the biological behaviour of mucinous breast carcinoma (MBC) regarding their clinical presentations, pathological features, prognosis and survival.Methodology: We conducted this retrospective study from 2006 to 2015 (10-year duration) and included all the patients who presented with mucinous carcinoma of the breast at any age. We excluded all the patients who presented with invasive ductal carcinoma or other rare breast tumours. Each patient with mucinous carcinoma breast was categorised in terms of diagnosis, surgery, chemotherapy and outcome. For categorical variables, Chi-square test was used. Kaplan–Meier curves were used to determine estimated overall survival. Data analysis was carried out using the SPSS 20.Results: In total, 8841 patients with breast carcinoma presented during the study period. Of these, 74 patients were diagnosed as cases of MBC, constituting <1%. Family history of breast carcinoma was positive in 20% of patients. Most of the women were postmenopausal (66.2%) falling in BIRADS Category 4 and 5 (32.4% each). Considering laterality tumours had almost equal distribution between the right and left side. Breast-conserving surgery was performed in 47.3% of women as compare to modified radicle mastectomy in 52.7% of women. Most of the patients had pathological T2 (51.4%), N0 (81.1%) and moderately differentiated (69%) mucinous carcinoma. ER was positive in 85% of patients, PR in 80% and H2N in 74.6% of patients. Neoadjuvant chemotherapy was given to 20 patients (27%) and adjuvant chemoradiotherapy was given to 51 patients (69%). Metastasis occurred in 12 (16.2%) of our patients while 62 (83.8%) were metastasis free on long-term follow-up, with bones being the most common site of metastasis, occurring in 6 patients (8.1%) followed by lungs, occurring in 4 patients (5.4%). A total of 32 (43.2%) patients are alive, and on regular follow-up, 3 (4.1%) died during the course of follow-up and 39 (52.7%) are lost to follow-up with a median survival of 60 months and an overall 5-year survival rate of >95%.Conclusion: Mucinous carcinoma is a rare breast carcinoma with a good prognosis.Key words: Breast cancer, mucinous carcinoma, prognosi
PENILE CANCER AND OUR EXPERIENCE AT TERTIARY CARE HOSPITAL
No full textPurpose: Penile cancer is a rare malignancy which accounts for <1% of adult male cancers. Phimosis, poor hygiene, smoking and human papillomavirus infection (type 16 and 18) are major risk factors for penile cancer. This analysis is to know the mode of presentation and treatment outcome of penile cancer in our setting.Materials and Methods: We reviewed case notes of all patients who had histologically proven penile cancer from January 2005 to December 2014. Patient’s demographics, predisposing factors, symptoms, type of tumour, treatment and its outcome were analysed using the Statistical Package for the Social sciences 19.Results: A total number of 19 patients who had histologically proven penile cancer were included in the study. Circumcision was done in 16 (84.2%), while 3 (15.8%) were uncircumcised. Most of the patients presented with a lesion 16 (84.2%) and the rest 3 (15.8%) with pain. Patients having delayed presentation by 1 year were 15 (78.9%), 3 (15.8%) after 2 years and one patient (5.3%) after 5 years. Partial and total penectomy were performed in 4 (40%) patients each while wide local excision in 2 (20%) of the patients (n = 10). 4 (30.7%) patients had complication of treatment. The overall 5-year survival was 69.2%.Conclusion: Penile cancer is an aggressive malignancy with generally poor outcome. There is a need of awareness amongst the masses of this cancer to detect the disease at an early stage. There is further need for specialised oncological centre to improve survival rates and outcome.Key words: Circumcision, penectomy, penile cancer, phimosi
SALVAGE SURGERY FOR ANAL CANAL CA. LONG TERM OUTCOMES FROM A TERTIARY REFERRAL CENTRE
No full textPurpose: The purpose of this study was to analyse the outcome of salvage surgery in the management of anal canal cancer.Methodology: All patients with a diagnosis of anal canal carcinoma from 2006 to 2015 were studied. Basic demographic data were recorded. Treatment modalities used were recorded for all patients. Long-term surgical outcomes were recorded. Median survival in months was recorded. All data were recorded in the SPSS ver. 20.Results: A total of 62 patients were included in the study. Median age was 51. 38 patients had SCCa on histology and 24 had an adenocarcinoma. 52% of patients had a T4 lesion. Chemoradiotherapy (CRT) was offered to 59 (95%) patients as the first line of therapy. 12 (19%) patients had a complete response. 37 (60%) patients had a partial and 10 (16%) patients had no response to chemoradiation. Salvage surgery was offered to 27 patients. Of these, 21 had a curative resection. Six had irresectable disease and underwent a colostomy only. Median overall survival for all patients was 46 months with a 5-year survival of 55%. Patients with partial response who were offered salvage surgery the 5-year survival were 40%. For patients with no response or progressive disease after chemoradiation therapy, the 5-year survival was 20%.Conclusion: Long-term survival can be achieved in majority of patients who undergo radical salvage surgery after failed CRT for carcinoma of the anal canal.Key words: Adenocarcinoma, anal canal, chemoradiotherapy, surger
SPINDLE CELL CARCINOMA OF LARYNX- A DISTINCT CLINICOPATHOLOGICAL AND HISTOLOGICAL ENTITY
Full text linkSpindle cell carcinoma (SpCC) is a variant of squamous cell carcinoma with biphasic components and more aggressive behaviour. Its rarity and histopathological pattern pose a diagnostic challenge. Early diagnosis and treatment result in a decrease in local and distant metastasis. Case 1 is a 71-year-old female presented with hoarseness of voice and dyspnoea for 2 years without any risk factors. Fibre-optic laryngoscopy (FOL) revealed smooth polyp hanging from anterior two-third of the left vocal cord. Microlaryngoscopic excision revealed SpCC followed by post-operative radiotherapy and is currentlyalive. Case 2 is a 72-year-old male presented with worsening stridor for 2 years post-excision of laryngeal nodule and history of smoking and hookah use for >20 years. He developed dysphonia after a few months with fixed hard level 3 nodes at the right side. FOL showed a polypoid mass extending from the left vocal cord into the supraglottis. Fine-needle aspiration cytology of the neck swelling confirmed the diagnosis of SpCC. Computerised tomography (CT) chest/abdomen showed distant metastasis. Palliative radiotherapy was given, but the patient died after 3 months due to locoregional failure. Case 3 is a 35-year-old male presented with a history of hoarseness for 3 years with no risk factors. FOL showed a 1.2-cm polypoid growth on the right vocal cord. Total laryngectomy was performed and histopathology showed SpCC. Radiotherapy was given and the patient is alive without disease with regular follow-ups. Smoking and alcohol are thought to be the contributing factors causing this disease. Biphasic nature of the tumour requires pathological sampling for diagnostic confirmation. Surgery combined with radiotherapy has a better survival outcome. SpCC is a rare tumour with a tendency for locoregionalrecurrence. Surgery should remain the mainstay of treatment followed by post-operative radiotherapy for a better control.Key words: Larynx, radiotherapy, spindle cell carcinom
USE OF SIMULTANEOUS INTEGRATED BOOST INTENSITY-MODULATED RADIATION THERAPY TECHNOLOGY IN LARYNGEAL CARCINOMA
Full text linkSEE YOUR ENDOCRINOLOGIST FOR A PITUITARY TUMOUR; YOU MAY NOT NEED SURGERY
Full text linkCushing’s syndrome remains an uncommon diagnosis with majority of non-specific and few specific clinical features suggestive of the condition. Results of biochemical investigations are often affected by confounding factors making diagnosis of Cushing’s syndrome difficult and localisation of the disease even more challenging. Careful assessment of the individual patient and use of the most suitable test in that patient may allow improved outcome in diagnosing and localising the condition to devise an appropriate management plan.Key words: Cushing’s syndrome, hypercortisolism, dexamethasone suppression test, Pseudo-Cushing’
FAMILIAL PAPILLARY THYROID CARCINOMA: A CASE SERIES
Full text linkThe natural history and inheritance of familial papillary thyroid carcinoma (FPTC) remain unclear. A specific genetic defect responsible for this condition and its inheritance is yet to be established. The penetrance, mode of inheritance and treatment of this familial thyroid condition are different from other familial thyroid conditions (familial medullary thyroid cancer). Presented here is a family of four sisters in which three developed multifocal PTC. A 47-year-old lady presented with incidental finding of multinodular goitre and normal thyroid function. She had three other sisters who were diagnosed with PTC at age 46, 48 and 49 years. Detailed clinical history of her sisters was gathered from them over telephone as they all moved to different parts of world in their twenties. Literature review was carried out to find similar patients reported in literature. Environmental factors were less important in the development of PTC in this family. It was also interesting that all three were diagnosed with the condition at a very similar age. FPTC behaviour was not more aggressive than sporadic form of disease. There is not enough evidence in literature to suggest prophylactic thyroidectomy in relatives of patients with PTC. Since the exact inheritance pattern of this condition is not known, detailed family history is important in patients with thyroid disorders to identify high-risk patients. Genetic factors are much more important than environmental factors in the development of this condition. The first-degree relatives should be assessed clinically for further investigations if two individuals in the same family develop the condition at similar age.Key words: Familial follicular thyroid cancer, familial papillary thyroid cancer, papillary thyroid cance
PICTORIAL REVIEW OF EXTRAOSSEOUS EWING’S TUMOUR: A SINGLE CENTER EXPERIENCE
Full text linkPurpose: Ewing’s family tumour is an extremely rare tumour, with annual incidence rates amongst Caucasian children <21 years being in the range of 2–3 cases per million in the U.S. There are mainly three subtypes including Ewing’s sarcoma (ES) of bone, extraosseous (EO) Ewing’s tumour and Peripheral primitive neuroectodermal tumour. Although extremely rare, this study represents a review of various types of cases and the significance of imaging including its baseline and post-treatment response radiological characteristics. There are a very few cases of EO ES in the current literature with variable spectrum of tumour site and their imaging characteristics.Materials and Methods: Electronic records were retrospectively reviewed from 1 May 2011 to 1 May 2016 with patients who were diagnosed as histologically proven ES. A number of patients, gender and base line computed tomography (CT)/magnetic resonance imaging findings for staging were reviewed.Results: A total of 568 patients with diagnosed ES were analysed, of which 15 patients had EO type of ES. Of these only 8 patients had baseline imaging available which included tumours arising from the occipital region, orbit, anterior mediastinum, anterior abdominal wall, mesentery, kidney, prostate gland and presacral region.Conclusion: EO ES is a rare entity and can involve a wide array of soft tissue organs. A cross-sectional imaging with CT and MR has a key role in pre- and post-treatment assessment.Key words: Computed tomography, Ewing’s sarcoma, extraosseous Ewing’s, magnetic resonance imaging, peripheral primitive neuroectodermal tumou