bluuebunny/crossref_metadata_2025 huggingface dataset:
A rare lung tumor: Primary pulmonary synovial sarcoma
Authors: Sahin Mehmet F. , Beyoglu Muhammet A. , Kıran Merve M. , Yekeler Erdal
Published: February 2024

Synovial sarcoma is one of the rare soft tissue sarcomas occurring in the periarticular region originating from synovia. Synovial sarcomas occur less frequently in the neck, tongue, larynx, mediastinum, heart, lung, abdominal wall, small intestine, mesentery, and retroperitoneum. Primary pulmonary synovial sarcoma is a poor pathological condition without extrapulmonary involvement. In these rapidly progressing tumors, making quick decisions is important and performing complete resection is the best treatment that contributes to survival. Herein, we present a case of primary pulmonary synovial sarcoma in which we were able to achieve long-term survival with the multimodal approach after complete resection.
A Comprehensive narrative review of transcriptomics and epigenomics of gallbladder cancer
Authors: Tanwar Pranay , Minocha Shilpi , Gupta Ishaan
Published: February 2024

ABSTRACTS

Gallbladder cancer (GBC) is one of the quiet prevalent and aggressive biliary tract malignant neoplasms distinguished by significant cellular heterogeneity, metastatic activity, and a poor prognosis, with varied frequency worldwide. Most cases are detected incidentally while routine screening imaging or pathological investigation of cholecystectomy tissues and usually present with advanced disease. The surgical resection is usually done in the initial clinical stage having limited spread. Despite the surgical therapy, the death rate is significant. Furthermore, the molecular mechanisms affecting the clinical course of inflammatory gallbladder to carcinogenesis remain poorly understood. There is an impending need for developing diagnostic biomarkers and targeted approaches for GBC. The newer molecular platform, such as next-generation sequencing (NGS), such as RNA-sequencing (RNAseq), single-cell sequencing, and microarray technology, has revolutionized the field of genomics, opened a new perspective in defining genetic and epigenetic characteristics identifying molecules as possible therapeutic targets. Therefore, in this review, we would analyze transcriptomic and epigenomics profiles of GBC using already published high-throughput sequencing-based studies published between 2010 and 2023. The review would also analyze the possible impact of the technological advancement on the patient management strategy and overall survival. This may also help identify target genes and pathways linked to GBC, which may help establish molecular biomarkers, for early GBC diagnosis, personalized therapy, and management.
Malignant solitary fibrous tumor of maxilla presenting as proptosis: A case report
Authors: Kumar Pravin , Jindal Arpita , Bhalgat Bhushan , Swain Phanindra Kumar , Sharma Raj Govind
Published: February 2024

Solitary fibrous tumor (SFT) is a fibroblastic mesenchymal neoplasm that rarely metastasizes. SFTs was first described in relation to pleura. However, occurrence of this tumor type has been reported in other sites like peritoneum, liver, adrenal gland, meninges and oral cavity. In head and neck region, oral cavity is the most common site of involvement. Most of the solitary fibrous tumors are benign and present as an asymptomatic slow growing mass. Surgery remains the mainstay of treatment. Hereby, we describe a case of 71-year-old male with malignant solitary fibrous tumor arising from right maxilla invading the right orbit presenting as proptosis.
Intra-operative intaoral ultrasonograpy ensures free deep resection margins in carcinoma tongue: A pilot study
Authors: Saharan Deepak , Verma Roshan K. , Ahuja Chirag , Bal Amanjit
Published: February 2024

Resection of primary in carcinoma tongue is challenging as the tumor often spreads submucosal and deep in muscles. There are various Intraoperative tools available to guide tumor resection margins. We studied the use of intraoperative ultrasound-guided resection for obtaining free deep resection margins in cases of oral carcinoma tongue. To assess the feasibility of resection of tongue tumor using intraoral ultrasound intraoperatively. 5 patients of oral tongue squamous cell carcinoma were included in this prospective pilot study. Intraoral ultrasound-guided resection of the primary tongue tumor was done. The surgeon moved the probe over the tumor and focussed on the point of maximum invasion by the tumor. A 26 G needle was passed in the tongue at a point that was 10 mm away from the deepest point of infiltration. It marked the deepest plane of resection. Following the above marking, a resection of tumor was done. Deep surgical resection margin was found to be >5 mm (free) in all the USG-guided surgically resected primary tongue tumors on histopathological examination. We have found intraoperative ultrasonography a useful tool for the surgical resection of primary tongue tumours.
Indirect hyperbilirubinemia because of eltrombopag in two cases after autologous hematopoetic stem cell transplantation
Authors: Gunduz Bahar Oztelcan , Atas Erman
Published: February 2024

The oral thrombopoietin receptor agonist eltrombopag has some side effects. One of them is related to bilirubin metabolism. Two patients with neuroblastoma in remission underwent stem cell transplantation with the Busulfan-melphalan regimen. Eltrombopag was started because of platelet engraftment failure. Indirect hyperbilirubinemia was detected after eltrombopag treatment. Laboratory and radiological investigations were all normal. The drugs and their side effects they used were examined. After eltombopag cutting, bilirubin levels of them returned to normal. These cases are presented to emphasize that eltrombopag can cause liver toxicity with hypertransaminesemia and hyperbilirubinemia. Drug side effects should be considered in the differential diagnosis of the patients. The significance of this case is that testing for serum aminotransferase and bilirubin levels should be monitored before and after eltrombopag use.
Expression of Claudin-4 and D2-40 and their significance in prostatic adenocarcinoma
Authors: Kabra Hardik , Mohanty Nihar Ranjan , Tripathy Sukanta , Mohanty Madhusmita , Senapati Urmila , Rath Jayashree
Published: February 2024

Background:

Claudins are a clan of proteins that are the most important component of tight junctions. The claudin-4 expression has been linked to tumour cell invasion and progression in a variety of primary malignancies. Evaluation of lymphovascular density (LVD) correlates with tumour aggressiveness and may correlate with prognosis. D2-40 is a highly specific marker of lymphatic vessels.

Aims:

To evaluate the claudin-4 expression in relation to LVD by D2-40 expression and with clinicopathological parameters in prostatic adenocarcinoma.

Settings and Design:

Prospective study

Materials and Methods:

39 cases of prostatic adenocarcinoma were taken, the D2-40 and claudin-4 immunohistochemical stains were performed and correlation was done with clinicopathological parameters.

Statistical Analysis Used:

Statistical analyses such as mean, median, standard deviation, Mann–Whitney U test, Fischer exact test, Spearman’s rank-order correlation coefficient, Chi-square test and T-test were used.

Results:

The claudin-4 expression was seen higher in cases with higher Gleason score but it was statistically non-significant (P = 0.778). The claudin-4 expression did not correlate with any clinicopathological parameters. LVD in the peritumoral area was significantly higher as compared to the intratumoral area (P = 0.005). Intratumoral LVD and perineural invasion were found to be statistically significant (P = 0.048).

Conclusion:

The claudin-4 expression may correlate with adverse prognostic parameters. Higher lymphatic vessels can be responsible for the higher metastatic potential of prostatic adenocarcinomas.
Cell-free SLC30A10 messenger ribonucleic acid (mRNA) expression and their association with vitamin-D level among non-small cell lung cancer (NSCLC) patients
Authors: Verma Amit K. , Naseeb Manal A. , Basaqr Reem O. , Albajri Eram A. , Khan Mohammad Idreesh , Dev Kapil , Beg Mirza Masroor Ali
Published: February 2024

Background:

Lung cancer has been major cause of cancer related death and day by day Non-small cell lung cancer (NSCLC) cases are increasing globally. Present study explored the link between SLC30A10 mRNA expression with vitamin-D level among the NSCLC patients.

Methods:

Present study included newly diagnosed 100 NSCLC patients and 100 healthy controls. Quantitative real time PCR was performed to check the SLC30A10 mRNA expression after cDNA synthesis from extracted total RNA from serum sample. Vitamin-D level was also analyzed in all the NSCLC patients by electrochemiluminscence based immunoassay method.

Results:

Present research work observed decreased SLC30A10 mRNA expression (0.16 fold) among the NSCLC patients, decreased SLC30A10 mRNA expression was linked with advanced stage (0.15 fold, P < 00001) of disease and distant organ metastases (0.11 fold, P < 00001) compared to its contrast. Decreased level of vitamin-D was also observed with advanced stage (17.98 ng/ml, P < 00001) of disease and distant organ metastases (16.23 ng/ml, P < 00001) compared to its contrast. Positive correlation was observed between SLC30A10 mRNA expression with vitamin-D level among the NSCLC patients suggesting decrease or increase in SLC30A10 mRNA expression mau decreases or increase the vitamin-D level. NSCLC patients with vitamin-D deficiency had 0.14 reduced SCL30A10 mRNA expression while insufficient (P = 0 .06) and sufficient (P = 0.03) showed comparatively high SCL30A10 mRNA expression.

Conclusion:

Study concluded that down regulation of SLC30A10 mRNA and vitamin-D deficiency may involve in advancement of disease and distant organ metastases. It was also suggested that the decrease of increase in SLC30A10 expression may cause the decrease of increase in vitamin-D level among the NSCLC patients may be involved in disease severity and worseness of NSCLC disease.
Hiccups: An atypical side effect experienced during chemo-radiotherapy in carcinoma nasopharynx
Authors: Pandey Ankita , Mishra Himanshu , Singh Pramod Kumar , Mishra Ritusha
Published: February 2024

Nasopharyngeal carcinoma is an uncommon cancer but has a distinct racial and geographic distribution. Patient presents with constellation of signs and symptoms due to its vicinity to critical structures and are best treated by conformal concurrent chemo-radiotherapy. We present a case of 45-year-old male diagnosed with carcinoma nasopharynx, referred to us for radiotherapy after three cycles of neoadjuvant chemotherapy. As per the prevailing standard of care, patient was planned for radiotherapy by volumetric arc technique with concurrent cisplatin. Initial days of treatment were uneventful. After fourth week of treatment, patient developed persistent hiccup which was not relieved on conservative medications. Plan was re-evaluated and it revealed maximum dose of 54.6 Gy to the brainstem. Radiotherapy induced edema that could have stimulated vagus nerve leading to hiccups was suspected. Patient was started on injectable steroid and chlorpromazine. There was prompt recovery from the symptom within five days of conservative treatment.
Multiple myeloma with oral manifestations as maxillary ulceroproliferative lesion: A case report
Authors: Thankappan Simi , Nedumpillil Sherin
Published: February 2024

Multiple Myeloma (MM) is the most common malignant neoplasm of bone and can manifest with different clinical features in oral cavity. MM lesions in skull and jaws have characteristic punched out lesions but are often confused with meningioma when they occur in skull as solitary lesions. We report a case of MM that reported in oral cavity for which prompt diagnosis was done, but there were symptoms that persisted for years and a skull lesion that was diagnosed and treated as meningioma before MM was diagnosed from the oral lesions. This is the first case where the patient has been actually treated for meningioma, and then diagnosed with MM after months. In that case, SBP or MM should be included in the differential diagnosis of a dural mass, particularly when a patient is complaining of neurological deficits. Also, the role of oral physician in the diagnosis of MM should be stressed in diagnosis and multidisciplinary management, thus facilitating better clinical outcomes.
Re-do cytoreductive surgery with hyperthermic intra-peritoneal chemotherapy (HIPEC): Risk factors and complications
Authors: Mishra Namita , Kumar Madhav , Singh Soumya , Rani Khushbu
Published: February 2024

An effective multi-modal treatment option for patients with peritoneal surface metastatic malignancies has progressed and developed over the decades as cytoreductive surgery (CRS), and hyperthermic intra-peritoneal chemotherapy (HIPEC) delivers highly concentrated, heated chemotherapy drugs directly to the abdomen during surgery. Peritoneal metastasis and high staging abdominal malignancies were considered incurable and end up with the palliation only; the CRS+HIPEC combination approach increases the median survival rate and gives a better quality of life to these patients. It is a complicated surgery which poses a high rate of complications and challenges which are difficult to manage and requires a multi-disciplinary approach. The aim of this study is to elaborate the perioperative possible physiological changes, risk factors, and related complications after re-do HIPEC.
A malignant transformation of borderline phyllodes tumor to fibrosarcoma breast: A rare case report
Authors: Kumar Madhu , Sagar Mala , Vimal Jitendra K. , Kumar Vijay
Published: February 2024

Phyllodes tumor of the breast with malignant transformation to fibrosarcoma of the breast is a rare entity. Breast fibrosarcoma is uncommon, accounting for less than 1% of all breast tumors. Prognosis of fibrosarcoma of the breast is poor. Due to its rarity, survival rates are not defined. A 23-year-old woman presented with a mass in the left breast, and another 48-year-old woman presented with right breast mass. Both patients underwent for surgery. The histological & immunohistochemical examination confirms the diagnosis of a malignant transformation from borderline phyllodes tumor to fibrosarcoma. We concluded that the phyllodes tumor is mostly benign but local recurrence is common. As the tumor progresses toward malignancy, due to the difficulty in the diagnosis of borderline phyllodes tumors, total mastectomy with axillary resection must be recommended.
A rare case of miliary tuberculosis in a patient with NSCLC receiving PD1 inhibitor therapy, mimicking autoimmune pneumonitis
Authors: Nikola Nikolic , Natasa Djurdjevic , Milica Kontic
Published: February 2024

Immune checkpoint inhibitors (ICIs) are widely used for the treatment of various types of cancer. One of the possible immune-related adverse effects of ICI is pneumonitis, which is a life-threatening condition that can present as a variety of radiographic patterns, so it can be difficult to differentiate from infectious cases of pneumonia based on radiological findings alone. We present a rare case of miliary tuberculosis (M. tuberculosis) in a patient receiving programmed death-1 (PD-1) inhibitor therapy mimicking autoimmune pneumonitis and possible pathophysiological mechanisms of this unexpected event. We presented a 52-year-old patient with stage IV non-small-cell lung carcinoma (NSCLC) who was admitted to the hospital with radiological and clinical signs of pneumonitis caused by immunotherapy—Pembrolizumab. During hospitalization, she was clinically, laboratory, and microbiologically processed and her diagnosis of M. tuberculosis was confirmed. Initial treatment started with corticosteroids as a pneumonitis treatment, and because there was no adequate response, and the diagnosis of tuberculosis was confirmed, treatment with a four-regimen antituberculotic drug started. On a control, CT scan regression in distribution and number of changes in lungs occurred. After a while, patient died due to hepatic failure. There are not many reported cases of pulmonary tuberculosis in patients receiving immunotherapy; to our knowledge, no cases of M. tuberculosis in a patient with lung cancer were described. Since there is a different approach to the treatment of tuberculosis and pneumonitis, we presented our dilemmas and literature review in this article. A multidisciplinary approach (oncologist, radiologist, microbiologist, etc.) is essential in a case like this.
Extent of extravasation: Patients on parenteral plant alkaloids
Authors: Somayaji Shalaka , Reddy Sangana S. , Murthy Mamatha K. , Maka Vinayak V.
Published: February 2024

Background:

Plant alkaloids remain an essential part of many chemotherapeutic regimens. Although many adverse effects have been studied with appropriate management guidelines, extravasation (EV) is one adverse event that is yet to be studied at a regional scale to frame population-specific guidelines.

Methodology:

A hospital-based observational study was done for 1 year to understand the extent of extravasation among patients on parenteral plant alkaloids. Clinical pharmacists congregated information about patients satisfying the study criteria. The incidence of EV injuries associated with parenteral plant alkaloids was assessed. The severity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) v4.3. The ESMO-EONS guidelines were followed for the classification of chemotherapeutic agents as well as management of the incidents of EV.

Results:

Among the 80 patients recruited into the study, 26.25% of patients experienced EV injuries, of which 66.67% were grade 2 and 33.33% were grade 3. Females were prevalent at 62% among the injured group. Patients in the age group 31–50 years and 51–60 years sustained 28.57% of the injuries each. In 76.19% of injured patients, ambulation status was positive during the infusion. ESMO-EONS drug classification showed that 54.84% of the drugs prescribed were vesicants. Paclitaxel was seen in 33.33% of prescriptions in the injured group, among other plant alkaloids.

Conclusion:

Our study saw a trend of vesicant-induced extravasation injury among patients prescribed parenteral chemotherapeutic regimens with a combination of plant alkaloids, indicating the significant risk they may pose.
Central nervous system metastasis in gynecologic cancers: Seeking the prognostic factors
Authors: Minareci Yagmur , Ak Naziye , Tosun Ozgur Aydın , Sozen Hamdullah , Saip Pinar Mualla , Topuz Samet , Salihoglu Mehmet Yavuz
Published: February 2024

ABSTRACTS

Objective:

Central nervous system (CNS) metastasis originating from gynecological cancer is a very rare and late manifestation of the disease. Therefore, there is still limited data on prognostic factors for survival. The objective of the present study is to identify prognostic factors for survival in patients with CNS metastasis originating from gynecological cancer.

Study Design:

The present retrospective study analyzed the patients with gynecological cancers who were treated due to CNS metastases between January 1999 and December 2019 at Istanbul University Hospital.

Results:

Forty-seven patients with CNS metastasis of gynecological origin were included in the study. The median age at the time of CNS metastasis was 59 (range 34–93). The median time from initial cancer diagnosis to CNS metastasis was 24.9 (range: 0–108.2) months. Most patients had epithelial ovarian cancer (EOC) (76.6%), followed by endometrial cancer (EC) (14.8%), cervical cancer (CC) (4.3%), and vulvar cancer (VC) (4.3%). By multivariate analysis, the presence of extracranial metastasis (HR: 5.10; 95% CI: 1.71-15.18), Eastern Cooperative Oncology Group (ECOG) performance status ≥3 (HR: 2.92; 95% CI: 1.36-6.26), palliative care only for the treatment of CNS metastasis (HR: 1.47; 95% CI: 0.58-4.11), and treatment-free interval (TFI) <6 months (HR: 2.74; 95% CI: 1.23-6.08) were independent factors that associated with worse survival.

Conclusion:

Patients with CNS metastasis who have favorable prognostic factors are considered to be appropriate candidates for aggressive and long-term treatment strategies. Extracranial metastasis, ECOG performance status, treatment history of CNS metastasis, and TFI were determined as independent prognostic factors that improved survival. TFI might be taken into account as a prognostic factor for patients with CNS metastasis in gynecological cancer.
Electron radiotherapy for EMPD of penis and scrotum
Authors: Lee Hye Kyung , Youn Seon Min , Shim Su Jung , Lee Mi Jo
Published: February 2024

Electron beams represent an important treatment modality for providing an accurate dose of therapy to superficial cancers. This case reports important findings of dermal invasion in patients with extramammary Paget’s disease (EMPD) using microscopic measurements and electron beam coverage. EMPD is a rare cutaneous adenocarcinoma generally arising in the anogenital region. Surgery is still a curable treatment option for patients with EMPD, whereas radiation therapy (RT) is an alternative for inoperable cases and is necessary in cases where surgery is not performed. This case report describes our experience and reviews the relevant literature on the feasibility of electron RT according to the dermal invasion length. An 80-year-old patient was diagnosed with EMPD and presented for definite radiation treatment. We observed no grade 3 toxicities during electron RT, and at the last follow-up visit, no signs of relapse were observed. There are no reports of electron irradiation as a feasible treatment option for EMPD considering the epidermal invasion length.
Personalized medicine in radiation oncology and radiation sensitivity index: Pathbreaking genomic way to define the role of radiation in cancer management
Authors: Mondal Dodul , Pareek Vibhay , Barthwal Mansi
Published: February 2024

ABSTRACTS

The technological developments associated with the branch of Radiation Oncology have been directed towards precise delivery of the dose, leading to improved survival in various solid malignancies. Radiation therapy as a treatment modality, is an integral component of more than half of the diagnosed malignancies. In spite of the role of adaptive radiation therapy evolving over the last decade, the fundamental question remains as to the difference in radiation response between individuals. Recently, the role of the radiosensitivity index has emerged, which has shown immense potential in the development of biologically driven tumor radiation therapy. The role of these novel methods of genome-based molecular assays needs to be explored to help in decision-making between radical treatment options for various malignancies and reduce the associated toxicity burden. In this article, we explore the current evidence available for various malignancy sites and provide a comprehensive review of the predictive values of various molecular markers available and their impact on the radiosensitivity index.
A pharmacological perspectives of Musa sapientum peels against lung cancer: An in vitro and in silico study
Authors: Praveena A , Saraswathi P L , Saranya V , Yuvarani A
Published: February 2024

ABSTRACTS

Context:

The essential role of medicinal plants is studied over 5000 years against the life-threatening diseases such as cancer in developing countries. The more cognizance on molecular mechanism will engender trend to use them efficaciously.

Aims:

To analyze the pharmacological activity of banana peel against lung cancer.

Settings and Design:

Banana fruit is a nutritious victuals with proven medicinal properties. The underlying molecular mechanism of phytochemicals present in the banana peel was studied using in vitro and in silico methods to explore an efficacious anticancer drug against lung cancer.

Methods and Materials:

The petroleum ether extract of Musa sapientum peel is analyzed using gas chromatography–mass spectrometry, in vitro studies using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl tetrazolium bromide (MTT), 2,2’-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and lipid peroxidase assay, and the in silico studies by molecular docking.

Statistical Analysis Used:

Microsoft Excel 2010 is used to calculate the mean and standard deviation for the ABTS and lipid peroxidation assay.

Results:

The antioxidant activity was found to be 20 µg/ml concentration in ABTS assay and 10 µg/ml concentration in lipid peroxidation assay. The in vitro anticancer activity was inspected using A549 cell lines by MTT assay. Tri cyclo [5,1,0,0 (2, 4) oct 5-ene 5 proponoic acid] 3,3,8,8 tetramethyl was selected as best lead against epidermal growth factor receptor of human based on the energy score calculated using the Auto-dock software.

Conclusions:

This study strongly supports that unexploited banana peels could be used to harvest promising lead molecules against non-small cell lung cancer.
XLOT regimen instead of FLOT regimen in the primary treatment for patients with locally advanced and metastatic gastric cancer
Authors: Işık Deniz , Koca Doğan
Published: February 2024

Aims:

To evaluate the efficacy and safety of docetaxel plus oxaliplatin and capecitabine (XLOT) in the treatment of locally advanced and metastatic gastric adenocarcinoma.

Methods and Material:

A total of 32 locally advanced gastric cancer (LAGC) and metastatic gastric cancer (MGC) patients in between 2019 to 2021 were enrolled into this study. Patients received XLOT regimen (docetaxel 50 mg/m2 and oxaliplatin 85 mg/m2 intravenous infusion on day 1, and capecitabine 2000 mg/day (day 1-14) orally. Treatment was repeated every three weeks.

Statistical Analysis Used:

Statistical data analysis was performed using the Special Package for the Social Sciences (SPSS) version 25.0 for Windows (SPSS Inc., Chicago, Illinois, USA). The Kaplan-Meier method was used for analyses of PFS and OS, and the two survival curves were compared using the log-rank test. A Chi-square test was used to compare independent group ratios. P values of < 0.05 were accepted as statistically significant.

Results:

The median age of 32 patients was 59.5 (26-79) years. The median cure count was 5 (1-11), and the median follow-up duration was 7 (3-19) months. The numbers of patients with compelete responsens (CRs), partial responses (PRs), stable disease (SD), and progressive disease (PD) were 6 (18.8%), 19 (59.4%), 5 (15.6%), and 2 (6.3%), respectively. The objective response rate (ORR) was 78.2%, with the disease control rate (DCR) of 93.8%. Median progression free survival (mPFS) and overall survival (mOS) were 11.7 (9.6-13.9) and 18.9 (15.4-22.3) month, respectively. The most common grade 3/4 toxicities were hematological toxicities. The most common toxicity was neutropenia which was observed in 18 (56.3%) patients. The most common grade 3/4 nonhematological toxicities were fatigue, nausea, vomiting, diarrhea.

Conclusions:

The XLOT regimen demonstrated a promising efficacy as the first-line regimen in treating locally advanced and metastatic gastric cancer patients. Toxicities were tolerated and controllable.
Unusual case presentation associated with impacted mandibular molars: Clinicopathological correlation and immunohistochemical analysis
Authors: Patil Karthikeya , Doddawad Vidya G. , Sanjay CJ , Shivananda S
Published: February 2024

Ewing’s sarcoma of bone is a rare malignant round cell tumor of the head and neck. The jaw, particularly the mandible, accounts for 3% of occurrences in the head and neck area. These tumors have been reported more frequently in men than in women, and they are usually between 5- and 20-year-old. It is difficult for clinicians and pathologists to make a diagnosis based solely on clinical and microscopic findings. Immunohistochemistry presents a plausible tool that can help the pathologist to arrive at a confirmatory diagnosis. This jaw tumor has the best prognosis when detected and treated early in the disease course, so the importance of timely, and accurate diagnosis cannot be overemphasized. The highlighting feature of this case report of an 18-year-old male that was primary detected by immunohistochemically as Ewing’s sarcoma and is localized to the impacted left mandibular molars.
Expression of BRCA1 by immunohistochemistry and its association with ER, PR, Her2neu status in infiltrative ductal carcinoma of breast
Authors: Soman Princy S. , Hemalatha A , Sreeramulu P. N.
Published: February 2024

ABSTRACTS

Background:

Breast cancer is a heterogeneous disease, which differs in its clinical behaviors and responses to treatment and outcome. The prognosis of breast cancer depends on histopathological parameters and molecular subtypes. Among more than 300 genes, which are involved in the pathogenesis of breast cancer tumor suppressor gene such as BRCA1 is known to play a significant role in hereditary cancers. However, its role in sporadic cases of infiltrating ductal carcinoma is yet to be established.

Aims and Objectives:

To evaluate the expression of BRCA1 in infiltrative ductal carcinoma and to analyze the association of BRCA1 with histopathological parameters and estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor2 (Her2) neu expression.

Materials and Methods:

This was a laboratory-based exploratory study in which 56 patients with infiltrative ductal carcinoma who underwent radical mastectomy from October 2019 to July 2021 were included. Patients with chemotherapy and radiotherapy, trucut biopsies, and incomplete patient details were excluded. Immunostaining for BRCA1 was performed. Individual clinicopathological parameters were compared with the BRCA1 mutation. Statistical analysis was done using SPSS 22. A P value of < 0.05 was considered statistically significant.

Results:

Among 56 cases of IDC, 18 cases (32.1%) showed BRCA1 mutation. BRCA1 mutation was associated with postmenopausal age, larger tumor size, lower tumor grade, and higher tumor staging. When we analyzed the biomarkers with BRCA1 mutation, it showed a negative association with ER, PR, and Her2 neu and a high Ki67 proliferation index. No family history of breast carcinoma was seen in 34/56 patients where history was available.

Conclusion:

Our study showed BRCA1 mutation in 32.1% and associated with postmenopausal age group, larger tumor size, and higher staging and negative hormonal status of breast carcinoma.
Pineal gland germinoma with spinal drop metastases: A case report and review of literature
Authors: Nath Jyotiman , Roy Partha S. , Sarma Gautam , Sarma Biswajit , Khanikar Duncan
Published: February 2024

Germ cell tumor of the central nervous system (CNS) is an infrequent entity consisting of only 0.2%–1.7% of all primary CNS tumors. The pineal gland is the commonest location of CNS germinoma. Traditionally, radiotherapy alone has been used to treat localized pineal germinoma, which has delivered a very high cure rate. Spinal drop metastases from pineal germinoma can develop after a long time from diagnosis and primary treatment. Currently, craniospinal irradiation is the standard of care in metastatic pineal germinoma with spinal drop metastases along with systemic chemotherapy. Very few cases of pineal germinoma with spinal drop metastases have been published in the literature. We report a pineal gland germinoma case with spinal drop metastases in an 18-year-old boy and reviewed the published literature.
Biochemical analysis of saliva in head and neck cancer patients receiving definitive chemoradiotherapy
Authors: Rani Savita , Singh Karuna , Banipal Raja Paramjeet Singh , Goyal Gitanjali
Published: February 2024

ABSTRACTS

Background:

Radiation therapy leads to salivary gland damage that causes xerostomia, the standard radiation-induced complication during radiotherapy that affects the quality of life in head and neck cancer patients. This study was conducted at a tertiary cancer institute in Punjab state to analyze the influence of radiation therapy on various parameters and substances of saliva.

Materials and Methods:

Sixty head and neck cancer patients who underwent conventional radiotherapy on a Cobalt machine were included. Saliva was collected in both stimulated and unstimulated states. Stimulated whole saliva was collected by applying two to three drops of citric acid solution (2%) over the dorsum of the tongue bilaterally at 30-s intervals for 2 min. Biochemical changes in the whole saliva were evaluated by biochemical methods at baseline, completion of therapy, and 3 and 6 months post-radiotherapy completion.

Results:

The lowest concentration of proteins was seen after the therapy in unstimulated and stimulated saliva. Salivary protein levels showed a rising trend toward baseline in 3- and 6-month posttherapy samples. The peak value (0.4 mg/dl) was reached in the stimulated saliva after therapy. Salivary amylase did not show a consistent concentration graph. The salivary concentrations of sodium, potassium, and chloride showed peak values after radiotherapy. The lowest salivary pH was obtained at completion of therapy, both in unstimulated and stimulated saliva. After 3 months of chemoradiotherapy, the saliva reached a pH value of 8.3, whereas 6-month posttherapy sample showed a pH value of 8.4 in both unstimulated and stimulated saliva.

Conclusions:

At the completion of chemoradiotherapy, the total salivary protein, albumin, and inorganic components (calcium, magnesium, phosphorus) showed a downward trend from the baseline values due to the damage caused to the acinar part of the salivary gland by radiotherapy. The rise in salivary electrolytes’ concentrations is attributed to the fact that even though there is loss of absorptive property of the tubular portion of the salivary gland, it retains its secretory property. Saliva becomes thick, scarce, tenacious, and acidic during the period of chemoradiotherapy.
Hidradenoma papilliferum at vaginal vault – A rare cause of vault growth
Authors: Jha Sangam , Sinha Jayanti , Sinha Ruchi
Published: February 2024

Hidradenoma papilliferum (HP) is a rare benign tumor of the apocrine gland and is commonly seen at the anogenital region. A 32-year-old post-hysterectomy woman presented with excessive vaginal discharge and itching. Small polypoidal mass was noted at vault. Excision of the lesion was done, and histopathology confirmed HP. The patient is symptom free following excision. This case report highlights the presence of pluripotent cells in the vagina and their differentiation into any cell lineage.
Development and validation of a comprehensive needs assessment tool to assess the burden of cancer chemotherapy patients attending a tertiary care hospital
Authors: Prakash G Hari , Kumar D Sunil , Kiran PK , Arun Vanishri , Yadav Deepika , Gopi Arun , Narayanamurthy MR
Published: February 2024

ABSTRACTS

Introduction:

In India in 2020, there were an estimated 1.39 million cancers present in the country. Chemotherapy patients experience several problems such as ADRs (adverse drug reactions), and because of this, many dropouts have been happening. Also, there is a lack of communication between the patient and care providers (doctors).

Objectives:

Development and validation of a comprehensive needs assessment tool to assess the burden of chemotherapy on patients attending tertiary level health care facilities.

Materials and Methods:

Development and validation of comprehensive needs assessment in cancer chemotherapy involve several steps, including problem statement and literature review regarding the problem, domain generation, development of the preliminary questionnaire, face validation, statistical validation, and final draft of the tool.

Results:

A total of 10 experts are involved in face validation. The majority (80%) of the experts agreed with the grammar, clarity, and content of the tool. A few experts (20%) disagreed regarding the construction of the questionnaire, the appropriate level of understanding for the participants, and the content of the tool and suggested changes in the physical and psychological domains. The questionnaire has been re-structured according to the expert’s suggestion before going for statistical validation. Internal consistency of the CNAT-CC was optimal, with a satisfactory Cronbach’s alpha of 0.7 for the total scale.

Discussion:

The current study was focused on the development and validation of needs assessment in cancer chemotherapy patients. The CNAT-CC promises to be a comprehensive needs assessment tool that applies to a comparatively vast majority of patients undergoing cancer chemotherapy.
Umbilical nodule – A not always innocuous abdominal finding
Authors: Ray Rubik , Baruah Tridip Dutta , Ravina Mudalsha , Kumar Deepak , Minz Treena
Published: February 2024

Sister Mary Joseph’s nodule is an umbilical nodule found in patients with metastatic abdominal cancers. It is quite rare finding and needs a high index of suspicion for diagnosis. Detection of Sister Mary Joseph’s nodule should warrant widespread search for abdominal carcinoma and it universally carries quite poor clinical prognosis. Here, we describe the case of a 28-year-old patient who presented with Sister Mary Joseph’s Nodule and was found to have metastatic signet ring cell gastric carcinoma on investigation. A brief discussion about this rare condition is also presented.
Overexpression of EGFR in esophageal squamous cell carcinomas – A new biological target in cancer therapy
Authors: Chakravarthy K Kavin , Pavithra V , Joseph Leena D. , Martin Jovita
Published: February 2024

ABSTRACTS

Background:

Esophageal squamous cell carcinoma (ESCC) is the predominant type of esophageal cancer in the Asian belt. These cancers show poor prognosis with an overall 5-year survival rate less than 19%. Exploring new molecular therapeutic targets such as epidermal growth factor receptor (EGFR) could be the corner stone of new curative treatment. The present study was done to analyze the overexpression of EGFR in different grades of ESCC and explore its role as a diagnostic and theranostic marker in ESCC.

Methods:

In this retrospective study, 50 formalin-fixed paraffin-embedded blocks of ESCCs diagnosed from 2014 to 2019 were retrieved. The biopsies were subjected to immunohistochemistry staining of EGFR. The intensity of the membrane staining was reviewed and scored. Compared with various intrinsic and extrinsic factors using Chi-square test, scores more than 2+ were considered as overexpression.

Results:

Majority (84%) specimens demonstrated overexpression of EGFR where high-grade ESCCs had greater overexpression rates compared to low-grade ESCC (P < 0.05).

Conclusion:

By targeting the EGFR molecules, anti-EGFR drugs could block their signals and stop the growth and spread of ESCCs especially high-grade tumors while harming the normal cells as little as possible. A clinical trial using anti-EGFR monoclonal antibodies will help in the long run to develop immunotherapy drugs.
Role of breast ultrasonography in predicting accurate tumor dimensions in correlation with histopathology and its impact on staging of breast carcinoma
Authors: Kathimanda Sahana T. , Hussain Nighat , Bugalia Amit , Sarangi Sujata
Published: February 2024

ABSTRACTS

Background and Objectives:

Estimation of the preoperative size of a breast tumor is of primary importance in deciding the treatment modality. Hence, clinical examination of the lump aided by the imaging is necessary. Our study is instrumental in correlating the size of breast tumor by high-resolution ultrasonography (USG) with the morphological size and also in comparing clinical staging of breast carcinoma against the gold standard pathological staging.

Methods:

It is a cross-sectional study of correlating the size of tumor on USG with the morphological size of biopsy proven invasive ductal carcinoma when received after excision. The size of the tumor was measured grossly and was compared with the USG measurements and palpatory findings.

Results:

Seventy percent of cases had good correlation between the USG and morphological size. In 50% of cases, the size on physical examination corroborated with the USG findings and only in 40% of the cases size on physical examination matched with morphological findings. In 65% of cases, the clinical staging of the breast carcinoma matched with the pathological staging. Our study reflected that USG promised to be the most useful radiological tool in predicting the accurate preoperative size of the tumor.

Interpretation and Conclusion:

We observed that USG has proved to be a very useful conjunct to clinical examination as only palpation was not found to be very accurate in predicting the actual tumor size. It proved to be safer and cheaper and effectively instrumental in meting out an effective management at pre- and postoperative level to the patient.
Description of clinicopathological characteristics of oral potentially malignant disorders with special focus on two histopathologic grading systems and subepithelial inflammatory infiltrate
Authors: Khan Abbas Saleem , Khan Zafar Ali , Nisar Muhammad , Saeed Saleha , Maryam Hoor , Haq Mohsina , Naushin Tehmina , Issrani Rakhi
Published: February 2024

ABSTRACTS

Objective:

This study was conducted to evaluate the clinicopathological features of oral potentially malignant disorders (OPMDs) with a focus on two histologic grading systems and subepithelial inflammatory infiltrates.

Materials and Methods:

This cross-sectional and multicenter study was conducted from April 2016 to September 2021 and comprised patients diagnosed with OPMDs. Hematoxylin and eosin-stained slides of 127 cases were assessed based on the World Health Organization (WHO) 2005 classification system, namely, epithelial precursor lesions and binary system of oral epithelial dysplasia (OED). Chi-square test and Fisher’s exact test were used to compare different categorical variables related to OPMDs.

Results:

The mean age of OPMD cases at presentation was 54.72 13.30 (P < 0.01) with a male to female ratio of 1.6:1. Oral leukoplakia (52.8%) was the most commonly diagnosed form of OPMD. Most OPMDs were classified as oral epithelial hyperplasia (59.1%) and the remaining (40.9%) as OED (P < 0.01). Of the 52 OPMDs with OED, all cases of mild dysplasia (36.5%) and carcinoma in situ (9.6%) were categorized as low-risk and high-risk lesions, respectively. Chronic inflammatory infiltrate (79.5%) was the most common subepithelial inflammatory alteration observed among OPMDs.

Conclusions:

Early detection of OPMDs is vital due to increased risk of developing into oral cancer. Timely clinicopathological risk assessment of OPMD is desirable for improving the prognosis and preventing the malignant transformation in oral premalignancy. Besides the epithelial precursor lesions’ classification by the WHO, binary system of grading OED use can be encouraged. Also, subepithelial inflammatory infiltrate can be of importance in future research regarding OPMDs.
Outcomes and prognostic factors in metastatic renal cell carcinoma patients with brain metastases
Authors: Dogan Izzet , Iribas Ayca , Paksoy Nail , Vatansever Sezai , Basaran Mert
Published: February 2024

ABSTRACTS

Background:

To evaluate the outcomes and prognostic factors in patients with brain metastatic renal cell carcinoma (bmRCC).

Methods:

The data of 322 patients with metastatic renal cell carcinoma, taken between 2012 and 2020, were retrospectively reviewed. Overall survival (OS) and prognostic factors were evaluated with Kaplan–Meier analysis and Cox regression analysis.

Results:

Forty (12.4%) of the patients had bmRCC. Seventeen (42.5%) of the patients were de novo metastatic, and nine (22.5%) of the patients had brain metastases at presentation. Twenty-four (60%) patients previously had received various therapies (tyrosine kinase inhibitor or checkpoint inhibitors). After brain metastases developed, 35 (87.5%) of the patients received brain radiotherapy (whole-brain radiotherapy or stereotactic radiosurgery), and twenty-five (62.5%) patients received different systemic therapies. Nine patients received sunitinib, nine received pazopanib, five received nivolumab, and two received axitinib. The median OS was 8.8 months (range: 2.9–14.6) for all patients with bmRCC. In univariate analysis, the number of brain metastasis (P = 0.35), the site of brain metastasis (left, right or bilateral) (P = 0.79), the largest size of brain metastasis (P = 0.45), the number of extracranial metastatic sites (P = 0.81), de novo metastatic disease (P = 0.17), primary tumor site (left or right) (P = 0.90), and tumor grade (P = 0.09) were not statistically significant factors on OS. However, age (P = 0.02), a history of nephrectomy (P < 0.001), receiving brain radiotherapy (P = 0.005), and type of systemic treatment (P = 0.04) were statistically significant. Only, the effect of brain radiotherapy on OS (P = 0.01) was confirmed in multivariate analysis.

Conclusions:

In this study, we observed that the prognosis of patients with bmRCC was poor. Despite a small number of patients, we detected that the effect of tyrosine kinase inhibitors and nivolumab was comparable, and receiving brain radiotherapy was a prognostic factor for OS.
Trend of tendency to critical thinking among medical students in Tehran University of Medical Sciences, 2010–2015
Authors: Najafi Minoo , Motlagh Maryam Karbasi , Najafi Maryam , Kashani Ahmad Sabouri , ostadzar Naser Faal , Zarghi Nazila , Shirazi Mandana
Published: February 2024

BACKGROUND:

Critical thinking is one of the goals of education. It is a criterion for academic accreditation in medical education by concentration on students' soft skills. Due to lack of basic information on critical thinking tendency in undergraduate medical program, this study aimed to determine the trend of tendency toward critical thinking of medical students in two phases: basic science (year 1) and preinternship (year 5) at Tehran University of Medical Sciences.

MATERIALS AND METHODS:

This longitudinal descriptive–analytic study has been conducted in two phases (2010 and 2015); all 105 medical students were selected by accessible sampling method. Years of entrance to college was the inclusion criterion. The psychometric properties of The California Critical Thinking Dispositions Inventory (CCTDI) were confirmed, and then, the instrument was completed twice by participants. Data were analyzed by SPSS: 16 using student t-test, and paired t-tests.

RESULTS:

There was a significant difference between genders of students (P < 0.05). Males were more disposed toward critical thinking than females. The significant increase was found between mean of truth-seeking in the second test compared to the first test; instead, the mean of inquisitiveness, analyticity and self-confidence and inquisitiveness was significantly decreased (P < 0.05). However, in other subscales, there were no significant differences between the 1st and the 5th year students (P > 0.05). The total score of the test in the second phase was lower than the first phase, which was not significant.

CONCLUSION:

According to the findings, there is necessary to consider the critical thinking dispositions in medical students training programs and break down the barriers. Tendency toward critical thinking seems to be as prerequisite of critical thinking skills in undergraduate medical program.