Neurofibroma of tongue

Neurofibroma is a conventional name indicating a nerve tumour resembling a fibroma without regard to its cell of origin (Boyd-1970). Neurofibroma of the tongue is a very rare condition. A review of the available literature records only thirty six cases of tumours of nerve sheath origin in the tongue (Bititci-1969, Grey & Kapadia 1972). Verocay (1908) was the first to describe the tumours arising from the nerve sheath and named them “Neurinomas”. A case of Neurofibroma of the tongue with its pathological features is reported.     

PET/CT assessment of neuroendocrine tumors of the lung with special emphasis on bronchial carcinoids

Pulmonary neuroendocrine tumors (pNETs) arise from bronchial mucosal cells known as enterochromaffin cells which are part of the diffuse neuroendocrine system. The pathological spectrum of pNETs ranges from low-/intermediate-grade neoplasms such as bronchial carcinoids (BCs), also known as typical or atypical carcinoids, to high-grade neoplasms as large-cell neuroendocrine carcinoma and small-cell lung cancer. The tumor biology of pNETs still represents a matter of open debate. The distinct features among the different pNETs include not only their pathologic characteristics but also their clinical behavior, epidemiology, treatment, and prognosis. In this sense, a correct pathological identification in the preoperative setting is a key element for planning the best strategy of care in pNETs and especially in BCs. Controversial results have been reported on the diagnostic accuracy of fluorine-18-fluorodeoxyglucose positron emission tomography or positron emission tomography/computed tomography (F-18-FDG PET or PET/CT) in BCs. On the other hand, there is increasing evidence supporting the use of PET with somatostatin analogues (DOTA-TOC, DOTA-NOC, or DOTA-TATE) labeled with gallium-68 (Ga-68) in pNETs. Herein, we review the pertinent literature aiming to better define the current state of art of PET/CT in the detection and histological differentiation of pNETs with special emphasis on BCs.     

Leiomyosarcoma of the nose and paranasal sinuses

Leiomyosarcoma of Nose and Paranasal sinuses is a rare tumour. 20 cases have been reported in world literature of Leiomyosarcoma of nose and P.N.S. An additional case of leiomyosarcoma of nose and P.N.S. is reported.     

Hereditary diffuse gastric cancer in a Japanese family with a large deletion involving CDH1

Hereditary diffuse gastric cancer (HDGC), characterized by susceptibility to gastric signet ring cell carcinomas (SRCCs) and caused by CDH1 germline mutations, is rare in the Japanese. We present here a Japanese family with HDGC identified by comparative genomic hybridization (CGH) analysis. A 55-year-old woman was treated with completion gastrectomy for multiple SRCCs, and pathological examination revealed approximately 200 foci of SRCC with loss of E-cadherin expression. Her 30-year-old son had surveillance endoscopy and was found to have multiple SRCCs. He underwent total gastrectomy, and 32 foci of SRCC with loss of E-cadherin expression were histologically found. Although no point mutations were detected in CDH1 by sequencing, CGH revealed a 275-kb deletion involving exons 7–16 of CDH1 in both patients. While only a few HDGCs have been reported in East Asia, patients with multiple SRCC may need to be offered appropriate genetic counseling and testing in this area.     

Broken tracheostomy tube-unusual presentations

Sporadically cases are reported about broken Tracheostomy tube as foreign-body in the tracheo-bronchial tree. The latest is from DR. S. C. Gupta (Journal of laryngology and otology, August 1987). Accordingly only twenty one have been reported. He reported nine cases over a period of eight years from Allahabad. We share our experience and views about the three cases of broken Fuller’s metallic Tracheostomy tubes as foreign-body removed from the nasophanynx and tracheo-bronchial tree (including a migratory type) within a period of one month (Apr. 1988) in the Institute of Oto-rhino-Iaryngology, Madras.     

Clinical Aspects of Malt Lymphomas

Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT) is an indolent lymphoma arising in extranodal sites. Several infectious agents and autoimmune disorders have been implicated in its pathogenesis. The stomach represents the most common and best-studied organ involved by MALT lymphoma and its development is strongly associated with Helicobacter pylori (Hp) infection. MALT lymphomas are characterized by an indolent clinical course and excellent survival in most cases, independently of the treatment delivered. Recent progress in the knowledge of the etiology and the cellular and molecular pathological events related to MALT lymphomas allowed us to improve our clinical understanding of this disease entity and to better define treatment strategies.     

Liposarcoma of the maxilla

A Case of Liposarcoma of the Maxilla in an 18 year old female is reported. The rarity of the disease and review of literature is discussed briefly.     

Pathological responses and survival of patients with human epidermal growth factor receptor 2-positive breast cancer who received neoadjuvant chemotherapy including trastuzumab

Background

The effectiveness of neoadjuvant chemotherapy is evaluated on the basis of pathological responses and survival outcome, because achievement of a pathological complete response (pCR) is a good predictor of long-term survival. However, few studies have assessed the survival of breast cancer patients who received neoadjuvant chemotherapy including trastuzumab.

Methods

The records of 161 breast cancer patients who received neoadjuvant chemotherapy between January 2006 and December 2011 were retrospectively reviewed. The patients were categorized into 4 subgroups on the basis of the status of the estrogen receptor (ER), the progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). HER2-positive patients received trastuzumab-based regimens. Pathological responses and survival were analyzed on the basis of breast cancer subtypes.

Results

The pCR results obtained were: luminal A and B (ER and/or PR-positive, HER2-negative), 6.3 % (5/79 cases); luminal–HER2 hybrid (ER and/or PR-positive, HER2-positive), 25.0 % (5/20 cases); HER2-enriched (ER and PR-negative, HER2-positive), 63.0 % (17/27 cases); and triple-negative (ER and PR-negative, HER2-negative), 25.7 % (9/35 cases). Achievement of pCR was a good predictor of disease-free survival in the HER2-enriched group. Overall survival of patients with pCR was slightly, but not significantly, better in the HER2-enriched and triple-negative subgroups.

Conclusion

Responses and survival after neoadjuvant chemotherapy including trastuzumab of patients with HER2-positive tumors differed among disease subtypes. Our findings suggest that disease subtype is an important determinant of the efficacy of neoadjuvant chemotherapy.     

The course of anxiety and depression for patients with Hodgkin’s lymphoma or diffuse large B cell lymphoma: a longitudinal study of the PROFILES registry

Purpose

The purpose of this study is to prospectively assess anxiety and depression among patients with Hodgkin lymphoma (HL) and diffuse large B cell lymphoma (DLBCL). Also, to compare its prevalence with a normative population, identify subgroups with more anxiety and depression, and assess its impact on health-related quality of life (HRQoL).

Methods

The population-based Eindhoven Cancer Registry was used to select patients diagnosed with HL or DLBCL from 1999 to 2010, 489 responded (T1). The HADS was completed four times (T1–T4), with a 1-year interval. Linear mixed-models were used to assess the course of anxiety and depression and identify high-risk subgroups.

Results

Both anxiety and depression were reported more often by patients compared to the normative population (p?p?DLBCL patients reported higher anxiety scores, whereas older DLBCL patients reported higher depression scores over time (p?Conclusion More HL and DLBCL patients experience anxiety and depression compared to their counterparts in the general population and it did not improve in time.

Implication for Cancer Survivors

Clinicians should be aware that former lymphoma patients with anxiety and depression have a deteriorated global health status/HRQoL and refer patients to suitable aftercare when necessary.     

Endemic (African) Kaposi sarcoma: Presenting as pathological fracture of left tibia and fibula

Kaposi sarcoma is a malignant vascular tumour of multifocal origin from undifferentiated vasoformative spindle cell. It presents frequently as cutaneous lesions, and musculoskeletal involvement is rare. Presented is a 52-year-old male farmer with inability to walk and pain of two months duration with cutaneous lesion noticed 3 years prior to presentation. Clinical, radiological and histopathological evaluation revealed cutaneous Kaposi sarcoma with a rare complication of pathological fracture of the left tibia and fibula with dystrophic calcification of the adjoining soft tissue. He had cytotoxic chemotherapy with poor outcome in cutaneous and skeletal lesions. Kaposi sarcoma if neglected presents with significant morbidity. Health promotion on early presentation and diagnosis are recommended for improved outcome.     

Relationships between VEGF protein expression and pathological characteristics of diffuse large B cell lymphoma: a meta-analysis

We carried out the current meta-analysis of relevant cohort studies in an attempt to investigate the relationships between vascular endothelial growth factor (VEGF) expression and pathological characteristics of diffuse large B cell lymphoma (DLBCL). The following electronic databases were searched for relevant articles without any language restrictions: Web of Science (1945?~?2013), the Cochrane Library Database (Issue 12, 2013), PubMed (1966?~?2013), EMBASE (1980?~?2013), CINAHL (1982?~?2013), and the Chinese Biomedical Database (CBM) (1982?~?2013). Meta-analyses were conducted with the use of STATA software (version 12.0, Stata Corporation, College Station, TX, USA). Odds ratios (ORs) and its 95 % confidence interval (95 % CI) were calculated. Nine clinical cohort studies with a total of 789 DLBCL patients met our inclusion criteria. The meta-analysis results showed that patients with positive VEGF expression had higher international prognostic index (IPI) scores than VEGF-negative patients (OR?=?5.12, 95 % CI?=?2.70?~?9.71, P?VEGF expression and evaluated lactate dehydrogenase (LDH) levels (OR?=?2.50, 95 % CI?=?1.36?~?4.60, P?=?0.003). We also found that patients with positive B symptoms had increased level of VEGF expression (OR?=?2.02, 95 % CI?=?1.08?~?3.77, P?=?0.027). The findings of our meta-analysis provide reliable evidence that VEGF expression may be strongly correlated with pathological characteristics of DLBCL.     

Angiofibroma in adult females

Two cases of Angiofibroma of Nose and Nasopharynx in adult females are being reported.     

Rhinoscleroma in a child

Rhinoscleroma is fairly common in the Northern and Central parts of India. The disease may present itself with many unusual features and may mimic many other diseases, specially Carcinoma. A patient with unusual features of Rhinoscleroma is being reported.     

Effect of Rifampicin on Rhinoscleroma

A rare case of Rhinoscleroma is reported. Its defenitive treatment being still in question. Rifampicin, a strong bactericidal antibiotic has been tried and found effective. In five years follow up no recurrence is noted. General aspects of the disease have been updated.     

Hamartoma of the nose

A Hamartoma of the Nose is being reported.     

Embryonal Rhabdomyosarcoma of middle ear and mastoid region

Embryonal Rhabdomyosarcoma is a relatively uncommon tumour of head and neck region. It is more common in children. In this paper two cases of Embryonal Rhabdomyosarcoma presenting in middle ear and mastoid region are reported.     

Osteoma of the ethmoid

A case of large Osteoma of ethmoid in female is reported.     

Congenital Crocodile Tear with Duane’s Syndrome

Congenital Crocodile Tear Syndrome is rare. There are 21 cases reported in literature. We add one more case to the list. All cases except one are associated with Duane’s Syndrome. Our case had an associated anomaly of the cervical spine. The relevant literature is reviewed.     

A rare case of leiomyosarcoma of the maxillary antrum

A case of Leiomyosarcoma of the maxillary antrum is presented along with a review of the medical literature. The clinico pathological aspects of the tumour are discussed. The mode of treatment is wide surgical excision with close follow up due to its high rate of recurrence. Radical neck dissection is indicated for metastatic nodal disease. The long term survival in this case is unusual.     

CXCL10 mRNA expression predicts response to neoadjuvant chemoradiotherapy in rectal cancer patients

Chemoradiotherapy has been commonly used as neoadjuvant therapy for rectal cancer to allow for less aggressive surgical approaches and to improve quality of life. In cancer, it has been reported that CXCL10 has an anti-tumor function. However, the association between CXCL10 and chemoradiosensitivity has not been fully investigated. We performed this study to investigate the relationship between CXCL10 expression and chemoradiosensitivity in rectal cancer patients. Ninety-five patients with rectal cancer who received neoadjuvant chemoradiotherapy (NCRT) were included. Clinical parameters were compared with the outcome of NCRT and CXCL10 messenger RNA (mRNA) expression between the pathological complete response (pCR) group and non-pathological complete response (npCR) group. CXCL10 mRNA and protein expressions between groups were analyzed using the Student’s t test and chi-square test. The mean mRNA level of CXCL10 in the pCR group was significantly higher than that in the npCR group (p?=?0.010). In the pCR group, 73.7 % of the patients had high CXCL10 mRNA expression, and 61.4 % of the patients in the npCR group had low CXCL10 mRNA expression. Subjects with high CXCL10 mRNA expression demonstrated a higher sensitivity to NCRT (p?=?0.011). The receiver operating characteristic curve showed that the diagnostic performance of CXCL10 mRNA expression had an area under the curve of 0.720 (95 % confidence interval, 0.573–0.867). There were no differences between the pCR and npCR groups in CXCL10 protein expression (p?>?0.05). High CXCL10 mRNA expression is associated with a better tumor response to NCRT in rectal cancer patients and may predict the outcome of NCRT in this malignancy.