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CASE REPORTS
Cannon ball opacities in chest from primary lung cancer: A rare presentation
Ruchi Sachdeva, Sandeep Sachdeva, Prem P Gupta
July-September 2013, 2(3):269-270
DOI:10.4103/2278-0513.119250  
Cannon ball opacities in lungs are usual manifestation of secondary's arising due to extra-thoracic malignancy. We report a rare case of primary lung cancer with presentation of multiple pulmonary nodules in a 62-year-old male laborer by occupation, chronic smoker (40 pack-years) who presented with 6 month history of dry cough, exertional breathlessness and fever off and on.
  11,851 84 -
ORIGINAL ARTICLES
Studies on the genomic association between schistosomiasis and hepatitis C virus infection
Akram M Abou-Zied, Tarek M El-Beltagy, Hekmat M Tantawy, Rasha H Soliman, Fouad M Badr
May-June 2015, 4(3):318-322
DOI:10.4103/2278-0513.151937  
Background: Schistosomiasis is an infection caused by blood flukes of the genus Schistosoma. Schistosomes are successful parasites, apparently as a result of prolonged co-evolution with their hosts. Studies done nationwide in Egypt found the highest risk of hepatitis C virus (HCV) co-infection is in those infested with schistosome without history of blood transfusions. However, the association between schistosomiasis and HCV infection is incompletely understood. Aims: The overall aim of this study was to assess whether or not a genomic association between schistosomal infestation and HCV infection exists. Materials and Methods: Oligonucleotide specific primers of HCV-polymerase chain reaction (PCR) diagnostics were used to screen the genomic DNA and cDNA library pool of Schistosoma mansoni as templates based on the end-point PCR approach. Results: Screening of schistosome DNA by PCR, lead to the detection of sequences similar to HCV. PCR products were obtained when adult worms genomic DNA were used as templates while no PCR products were amplified from S. mansoni λZAPII cDNA library pool. The resulting PCR products were sequenced and compared with the other closely related HCV sequence database at the website < http://hcv.lanl.gov>. Conclusions: This work demonstrates the existence of HCV and its replication in the genomic DNA of S. mansoni. In addition, it highlights the fact that the parasite can carry the virus genome and therefore, is considered as a nonhuman vector for the transmission of HCV infections.
  11,465 66 -
Clinical outcome and pattern of recurrence in patients with triple negative breast cancer as compared with non-triple negative breast cancer group
Aramita Saha, Subrata Chattopadhyay, Mohammad Azam, Prabir K Sur
October-December 2012, 1(4):201-205
DOI:10.4103/2278-0513.106256  
Aim: To compare the clinical characteristics and outcomes in terms of survival, propensity and time of local and distant recurrence for women with triple-negative breast cancer (TNBC) to women with non-triple negative breast cancer (NON TNBC). Materials and Methods : A retrospective cohort study was done with 1,026 breast cancer patients with known receptors and Her2neu status diagnosed between January 2005 and January 2011. Statistical Analysis: Comparison of clinical outcomes between the two groups was done using t-tests for mean and chi square tests for frequencies. For overall and recurrence-free survival Kaplan-Meier survival analyses were done. Results: The mean follow-up time for TNBC was 2.9 years and NON TNBC was 4.1 Years. Among the total 1026 patients, 312 patients (30.4%) had TNBC. Compared with non TNBC, those with TNBC had an increased likelihood of death [27.8% vs. 17.8%, P < 0.0008, > 95% confidence interval (CI)], and distant recurrence (41.48% vs. 33.17%; P = 0.02, C I >95%). Visceral metastasis was high in TNBC which showed Brain metastasis (21.11% vs. 6.18%, P < 0.0002), liver metastasis (15.56% vs. 5.02%, P < 0.0002), lung metastasis (25.19% vs. 10.03%, P < 0.0002); while bone metastasis was higher in NON TNBC group (5.2% vs. 20.55%, P < 0.0002). Conclusions: TNBC have a more aggressive clinical course and adverse outcomes as compared to NON-TNBC, but local tumor size and propensity of local recurrence do not vary significantly with receptor status. Though, chance of visceral metastasis is higher in TNBC, bone metastasis is high in NON-TNBC.
  10,069 1,300 -
REVIEW ARTICLES
Myoepithelial cells: Current perspectives in salivary gland tumors
C Pramod Redder, V Suresh Kandagal, Nupura Vibhute, Pramod S Ingaleshwar, Sharan J Shetty, Sameer Ahamad
April-June 2013, 2(2):101-105
DOI:10.4103/2278-0513.113624  
Myoepithelial cells are normal constituent of the salivary acini and smaller ducts, and are found between the epithelial cells and the basement membrane. Microscopic examination shows that myoepithelial cells are thin and spindle-shaped and situated between the basement membrane and epithelial cells. Ultrastructurally they possess a number of cytoplasmic processes that extend between and over the acinar and ductal-lining cells. They display features of both smooth muscle and epithelium, such as numerous microfilaments with focal densities in the cytoplasmic processes, and desmosomes which attach the myoepithelial to the epithelial cells. Neoplastic myoepithelial cells in both benign and malignant tumors can take several forms, including epithelioid, spindle, plasmacytoid, and clear, and this variability largely accounts for difficulties in histopathological diagnosis. This review article highlights the role of myoepithelial cells in salivary gland tumors.
  8,038 549 2
ORIGINAL ARTICLES
Clinico-pathological study of breast carcinoma: A prospective two-year study in a tertiary care hospital
Kaushik Saha, Gargi Raychaudhuri, Bitan Kumar Chattopadhyay
January-March 2013, 2(1):34-40
DOI:10.4103/2278-0513.110773  
Background: Breast cancer is the most frequent cancer in female, both in developed and developing regions, and ranks second overall next only to lung cancers. International variation in both incidence and mortality is one of the most striking features of breast cancer. Aims: To assess the clinical profile of the patients of breast carcinoma as well as relevant macroscopic and microscopic features of the mastectomy specimens. Materials and Methods: The present prospective study was carried out on clinically suspected and pre-operative FNAC-confirmed 120 cases of breast carcinoma who were admitted in the department of surgery for mastectomy during the study period of two years. In addition to relevant clinical features, macroscopic and microscopic features of mastectomy specimens were noted. Results: Mean age of the study population was 46.53 years. Most of the patients presented with breast lump with or without other features. Mean tumor size in the study population was 5.91 cm with standard deviation ± 2.59. Most of the cases (90.8%; 109 cases out of 120 cases) were diagnosed as IDC, NOS (Infiltrating ductal carcinoma, not otherwise specified). Mostly (62 cases; 51.7%), we got the histological grade 3 tumors. Lympho-vascular invasion was identified in 25.8% cases (31 cases out of 120 cases). Skin and nipple areola was involved in 15.0% cases (18 cases). Conclusion: IDC, NOS is the most common histologic type of breast cancer in our study population. Most commonly affected age group by breast cancer is 35-50 years. In most of the cases, size of the mass was more than 5 cm involving multiple quadrants of breast and with positive lymph nodes. Histologically, grade 3 tumor is most prevalent in this population.
  6,460 1,535 -
Fine-needle aspiration cytology and biopsy in hepatic masses: A minimally invasive diagnostic approach
Jitendra G Nasit, Viren Patel, Biren Parikh, Manoj Shah, Kajal Davara
April-June 2013, 2(2):132-142
DOI:10.4103/2278-0513.113636  
Aims and Objective: To evaluate the diagnostic sensitivity, usefulness and limitations of fine-needle aspiration cytology (FNAC) and fine-needle aspiration biopsy (FNAB) in the diagnosis of hepatic masses. Materials and Methods: FNAC was performed on 150 cases of hepatic masses under guidance of ultrasound or computed tomography (CT) scan. Adequate diagnostic aspirates were obtained in 147 cases (98.0%). Smears were stained with hematoxylin and eosin (H and E), and Papanicolaou stains. FNAB was obtained from the same 149 cases (except one) and stained with HE stain. The hepatic masses were categorized into benign, malignant and inflammatory groups. Results: Out of 150 hepatic masses, 3.3% were benign, 94.26% were malignant and 2% were inflammatory lesions. FNAC and FNAB were unsatisfactory for evaluation in 3 out of the 150 cases (2%) and 6 out of 149 cases (4.02%), respectively. Correct cytological diagnoses were achieved in 129 out of the 150 cases (diagnostic sensitivity: 86%). FNAB gave satisfactory results in 143 out of 149 cases (diagnostic sensitivity: 95.77%). Cytological diagnoses of 21 cases were not consistent with histology (false negativity: 14%). Cyto-histological correlation showed 87.32% diagnostic sensitivity of FNAC for malignant tumors, whereas benign tumors posed maximum diagnostic problems, with sensitivity of 40%. This difference was statistically significant (P < 0.05). FNAB showed a statistically significant difference (P < 0.05) compared with FNAC in the diagnosis of benign and malignant hepatic masses. FNAC showed 100% diagnostic sensitivity for inflammatory lesions. Conclusion: Malignant tumors of liver can be confidently diagnosed on FNAC. However, FNAC has a few limitations and diagnostic challenges in benign lesions, well-differentiated and poorly differentiated hepatocellular carcinoma, and metastatic carcinoma. Microhistology by FNAB allows architectural, cellular and immunohistochemical evaluation. To obtain maximum diagnostic information with reduction of indeterminate reports, a combined approach of FNAC and FNAB with clinical findings, tumor markers and ancillary techniques should be used.
  7,098 191 1
REVIEW ARTICLE
Interventional role of Haridra (Curcuma longa Linn) in cancer
Zankhana M Buch, Jayashree Joshi, Ashok Amonkar, Ashok B Vaidya
April-June 2012, 1(2):45-50
DOI:10.4103/2278-0513.99556  
Haridra (Curcuma longa Linn (Zingiberaceae family)) is a rhizomatous household spice and has been a widely used herb in India since ancient times. Ayurvedic pharmacodynamics of C. longa are described as follows: Rasa - tikta and katu, Guna - rukhsha and laghu, Virya - ushna, Vipak - katu and Doshaghnata - tridoshshamak. It is used as a tonic, carminative, antidiarrheal, hepatoprotective and as a purifying agent. It is also used in cancer management. Since years, haridra has been used as a hemostyptic agent. However, the oncopreventive aspect of haridra has drawn the scientists towards it. Use of haridra in medoja arbuda is documented in Sushrut Samhita. Recently, it has been found that chronic inflammation has played a role in cancer formation. The kapha and vata shamaka property is responsible for the shothghna activity of haridra. Several studies have also proved the anti-inflammatory condition of haridra. The essential oil, containing ar-turmerone, as a major component has been shown to possess anti-inflammatory effect of haridra. Experimental studies 'in vitro and in vivo' in diverse models have also proved the anti-tumor activity of haridra. Curcumin,the chief ingredient, of it is mainly responsible for anticancer property. However other constituents like Turmerone and polysacchrides also play a major role in anti cancer activity. The free radical scavenging activity as well as inhibition of lipid peroxidation by curcumin has been reported by Kuttan et al. The mechanisms underlying the anticancer potential of curcumin are complex. Many reports in literature mention about that work carried out regarding the suppression of proliferation of cells of different tumors. They include the down regulation of transcription factors, inhibiting COX2, LOX, inducible nitric oxide synthase, matrix metalloproteinases 9, cell adhesion molecules along with TNF-α. Curcumin inhibits TNF-α-induced AKT activation whereby levels required for NFkβ gene expression are suppressed. Curcumin suppresses the tumor angiogenesis resulting in regression in the tumor metastatic growth. Goel et al. have shown the inhibition of expression of COX2 in human colon tumor cell line (Vaidya et al.). Kuttan et al. showed that the ethanol extract of turmeric as well as the ointment of curcumin produced remarkable symptomatic relief in 62 patients with external cancerous lesions. Scientists at institute of cytology and preventive oncology (ICPO) based in Noida, UP, have found that curcumin protects body from HPV that is one of the primary causes of cervical cancer. Bhide et al. showed the therapeutic effect of turmeric oil and turmeric oleoresin on oral submucous fibrosis (SMF) patients. At MRC KHS, a cervical cancer prevention study was approved by an independent ethics committee. The primary objective was to see whether administration of oral turmeric oil for a period of 12 weeks, resulted in the arrest or regression of the premalignant condition, LGSIL, i.e. low grade squamous intraepithelial lesion as detected by Pap smears during the therapy period. It was observed that the lesion in Pap smears was arrested in 3/19 cases and regressed in 16/19 cases (Joshi et al, Asian Pac J Cancer Prev 2011). Experimental data suggest that curcumin acts at each stage of promotion, progression, and metastasis of cancer. Haridra which has anticancer potential ,can be considered as complementary medicine for cancer treatment as well as prevention.
  6,098 307 -
REVIEW ARTICLES
Recent advancements in the diagnosis of oral premalignant and malignant lesions: A comprehensive review
Manish Gupta, Manas Gupta, Avanti Aggarwal, Ravish Ahuja
July-September 2013, 2(3):181-184
DOI:10.4103/2278-0513.119249  
The diagnosis and treatment of lesions are currently based on histopathology, which is the gold standard for the diagnosis of cancer and dysplasia at the molecular level. Recently, there has been an increasing trend of optical spectroscopy methods for the detection of oral premalignant and malignant lesions and the same is highlighted in this paper. It depends on the optical spectrum derived from any tissue that contains information about the histological and biochemical make-up of that tissue. It provides tissue diagnosis in real-time, non-invasively, and in situ.
  5,689 689 -
ORIGINAL ARTICLES
Tumor angiogenesis: A potential marker of the ongoing process of malignant transformation in leukoplakia patients, removing the veil
Mubeen Khan, Abhishek Singh Nayyar, HC Gayitri, UD Bafna, Siddique Ahmed
July-September 2012, 1(3):127-134
DOI:10.4103/2278-0513.102880  
Context: The diagnosis of malignant and potentially malignant epithelial lesions of the oral mucosa is based on a careful histologic evaluation of a representative biopsy specimen. The site for the biopsy, however, is always a subjective choice that raises doubts about its representativeness. So far, no simple and reliable method is available for selecting the most appropriate area for biopsy. Colposcopy, a well-known gynecological diagnostic procedure, is helpful in the selection of these sites of epithelial dysplasia depending upon the vascular patterns. Aims: The present study aimed at assessing the vascular patterns by colposcopic findings and selecting the biopsy site in leukoplakia patients and compared the two methods, clinical criteria, and colposcopic examination, for selecting the biopsy site. Settings and Design: Sixty patients between the ages of 30-60 years clinically diagnosed with leukoplakia were included in the study. Materials and Methods: For each of the subject, a thorough clinical examination was carried out followed by colpospopic examination for the selection of biopsy site. The histopathological findings were then compared in the two cases. Statistical Analysis Used: The statistical analysis was done using paired t-test. Results: Based on clinical criteria, a sensitivity of 0.5714 (57%) and a specificity of 0.5000 (50%) and that guided by colposcopic examination to be 0.8571 (85%) and 0.6667 (66%), respectively, was found. Conclusions: From the study, it was concluded that colposcopic examination could prove to be a valuable diagnostic adjunct in the selection of biopsy site for leukoplakia patients.
  4,887 184 1
REVIEW ARTICLES
Volumetric intensity modulated arc therapy in lung cancer: Current literature review
Suresh B Rana
January-March 2013, 2(1):9-13
DOI:10.4103/2278-0513.110758  
The volumetric intensity modulated arc therapy (VMAT) is a novel radiation technique that delivers a highly conformal radiation dose to the target by allowing the simultaneous variation of gantry rotation speed, dose rate and multiple-leaf collimators leaf positions. The aim of this study was to review the current literature on two VMAT systems, RapidArc and SmartArc with main focus on planning studies of lung cancer. A systematic review of available data was conducted using MEDLINE/PubMed with the keywords ''lung'' and "VMAT". The published data show that VMAT techniques have clear superiority over three-dimensional conformal radiation therapy with regard to improving dose conformity and sparing of organs at risks (OARs). The data indicates that for lung tumor VMAT and intensity modulated radiation therapy (IMRT) provide equivalent dose homogeneity, dose conformity and target volume coverage; however, contradictory results were obtained in terms of OARs sparing. The major advantages of VMAT over IMRT are the reduction in the number of monitor units and faster treatment delivery times without compromising the quality of the treatment plans. Moreover, faster delivery time is more patient-friendly and it minimizes intra-fractional patient motion allowing treatment volumes stay within their respective treatment margins. Current literature data shows that VMAT can be a good option to treat lung cancer; however, data on clinical trials are still lacking. The clinical trials are essential to confirm the safety and efficacy of VMAT techniques.
  4,130 850 1
REVIEW ARTICLE
Vital tissue staining in the diagnosis of oral precancer and cancer: Stains, technique, utility, and reliability
Udyavara Sridhara Sudheendra, Huchanahalli Sheshanna Sreeshyla, Raju Shashidara
March-April 2014, 3(2):141-145
DOI:10.4103/2278-0513.130156  
Early diagnosis is the single most factors that improve the prognosis and survival rate of cancer patients. Numerous adjuncts are available to aid in its diagnosis. Vital tissue staining is one such adjunct used in the diagnosis of cancer. Though not a new technique, its application to cancer diagnosis especially in its premalignant stage is still uncertain. While the efficiency of toluidine blue (TB) is established to certain extent, the role of other vital stains needs to be researched. This article reviews the various vital tissue staining techniques available in the diagnosis of oral precancer and cancer.
  4,129 216 2
CASE REPORTS
Fibroadenoma in male breast: Case report and review
Sunder Goyal, Snigdha Goyal, Aseem Trikha
March-April 2015, 4(2):220-222
DOI:10.4103/2278-0513.152754  
Fibroadenoma is very common in females, but rare in male breast. Gynecomastia and/or lobular differentiation have been known to coexist in both types of fibroepithelial lesion in men. We report a young adult having gynecomastia associated with fibroadenoma.
  4,197 4 -
REVIEW ARTICLES
Nuclear medicine in dentistry revisited: New avenues to explore
Vinita Boloor, Rajesh Hosadurga, Sruthy Pratap, Anupama Rao
July-September 2013, 2(3):189-194
DOI:10.4103/2278-0513.119253  
Nuclear medicine and radioactive tracers have considerable application in dental research, because they provide one of the few practical methods for studying the limited metabolic activities of bones and teeth. The ease with which minute amounts of these radioactive materials may be accurately measured and distinguished from the mass of inert element in the tooth is particularly valuable. They are useful in studying many problems of calcification and mineral exchange. There are also opportunities of their use in investigating fluorosis, caries protection, periodontal disease, micro leakage studies of dental materials, root resorption, nutritional, and endocrine effects, as well as numerous other dental problems. Other usages of nuclear medicine in dentistry are listed below: Age written in teeth by nuclear tests, scintigraphic evaluation of osteoblastic activity, and evaluation of osteoblastic activity around dental implants using bone scintigraphy. Nuclear medicine can be an indicator of "active" alveolar bone loss. Nuclear medicine techniques are used as an adjunct for the diagnosis of oral diseases (benign tumors and carcinomas) and temporomandibular joint disease. This review article discusses these indications of nuclear medicine.
  3,862 208 -
CASE REPORTS
Giant cell tumor of ilium: An unusual location
Satyavir K Mathur, Monika Garg, Divya Sethi, Sheena Khetarpal
April-June 2012, 1(2):80-82
DOI:10.4103/2278-0513.99572  
Giant-cell tumor (GCT) is a histologically benign, locally aggressive tumor that typically affects the ends of long bones, most commonly involving distal femur, proximal tibia, distal radius, and proximal humerus in the order of frequency. The involvement of flat bones of pelvis is extremely rare. We herein describe the unusual case of histologically benign GCT at ilium distinguished by marked destructive features on X-ray, CT, MRI, and histological examination necessitating hemi-pelvectomy in a 15-year-old female. Characteristics features of the giant cell tumor and its treatment options are reviewed.
  3,891 154 1
REVIEW ARTICLES
Post-mastectomy radiotherapy for one to three axillary node positive early breast cancer: To radiate or not to radiate?
Sayan Paul, Kirti Srivastava, Tamojit Chaudhuri, Srinivas Rathor
January-March 2013, 2(1):14-19
DOI:10.4103/2278-0513.110760  
Post-mastectomy radiotherapy (PMRT) in early breast cancer has long been a matter of debate among oncologists. The American Society of Clinical Oncology (ASCO) and the American Society for Therapeutic Radiology and Oncology (ASTRO) recommend the use of PMRT for patients, whose primary tumor is larger than 5 cm and/or patients who have four or more involved axillary lymph nodes (ALNs). Recently, few trials have been published showing the positive impact of PMRT on overall survival (OS) even in patients having 1-3 positive ALNs with T1-T2 primary disease or early breast cancer (EBC). So, it has become a matter of controversy whether to radiate or not to radiate? We have made an extensive search in the internet in Pubmed and other sites of medical publication mentioning our topic of discussion and reviewed the relevant articles. We nearly got 3,220 articles. After reviewing the available publications in the internet, we blended the elixir with our experience and tried to find an answer of our question. In conclusion, PMRT significantly and substantially improved loco-regional control and overall survival in patients with 1-3 positive nodes as in patients with 4 or more positive nodes, and nearly the same number of patients is needed to treat to avoid a loco-regional recurrence and/or death in both groups. We should reconsider the current guidelines for the indication for PMRT.
  3,513 296 -
CASE REPORTS
Dentigerous cyst involving mandibular third molar: Conservative treatment with radiologic follow-up and review of literature
Ankit Goel, Prashant Patil, Richa Bansal, Robin Sabharwal
July-September 2013, 2(3):233-236
DOI:10.4103/2278-0513.119266  
Dentigerous cyst is the second most common odontogenic cyst and constitutes around 20-24% of all the odontogenic cysts involving the jaws. Usually, these cysts remain asymptomatic and rarely cause enlargement and displacement of associated tooth. In this paper, we present a case of a displaced mandibular third molar, which was associated with a large dentigerous cyst. A conservative treatment modality was adopted with a 2 year radiographic follow-up of the patient. A brief review of previously reported cases with dentigerous cyst causing displacement of the mandibular impacted third molars is also discussed, highlighting the treatment modality followed in all these cases.
  3,578 152 -
REVIEW ARTICLES
Oral cancer as a leading annoyance of the South Asian territory: An epidemiologic and clinical review
Vineet Gupta, Puneet Kumar, Prince Kumar, Suresh Yadav, Ashish Khattar, Shallu Tyagi
October-December 2012, 1(4):196-200
DOI:10.4103/2278-0513.106252  
Oral cancer is one of the most fatal health problems faced by the mankind today. In India, because of cultural, ethnic, geographic factors, and the popularity of addictive habits, the frequency of oral cancer is high. It ranks number one in terms of incidence among men and third among women. Several factors such as tobacco and tobacco-related products, alcohol, genetic predisposition, and hormonal factors are suspected as possible causative factors. The exciting opportunity provided by the well-established oral precancerous lesions for intervention and early detection programs is also discussed. The poor survival revealed by existing studies is mainly due to the overwhelming proportion of advanced cases. The excellent opportunity for more research and efforts in prevention and control of oral cancer in India is highlighted in this review. Here authors sought to epidemiologically review oral cancer in South Asian province with special focus on major risk factors and future perspectives.
  3,547 166 1
ORIGINAL ARTICLES
Latissimus dorsi myocutaneous flap for cover of soft tissue defects: Experience of a regional cancer center of North East India
Abhijit Talukdar, Joydeep Purkayastha, Bibhuti B Borthakur, Bhabesh K Das, Amal C Kataki, Manigreeva Krishnatreya
January-February 2014, 3(1):58-61
DOI:10.4103/2278-0513.125796  
Background: Most of the oncological surgeries require extensive resection of tumors and repair of the defects with flaps. Aim: In this series the role of using latissimus dorsi myocutaneous flap (LDMF) for oncoplastic replenishment of soft tissue defects involving breast, chest wall, and back was explored. Materials and Methods: The patients in this study are cases treated at a regional cancer center in the northeast India. During the period from January 2010-January 2013, 18 cases of LDMF reconstruction were performed in our center and are included in this series. Results: The patients were in the age range of 10-50 years with a follow-up period ranging from 6-24 months. All patients underwent immediate reconstruction of the primary defect. In our series out of 18 patients, in 13 patients the flap had healed primarily without flap congestion, margin necrosis, or infection. The following minor postoperative complications were observed, like wound infection with skin necrosis in one patient (5.5%) and seroma formation was see at both the donor site and at the defect site in four patients (22%). Conclusion : LDMF should be utilized more often, as it is technically a straightforward procedure that provides adequate coverage of varied defects, acceptable cosmetic outcomes with minimal postoperative complications.
  3,571 62 -
REVIEW ARTICLES
Nanogoldtechnology-imaging, sensing and target therapy in head and neck cancer
Nishat Sultana, Suraksha Bhat Shenoy, ME Sham, Shilpa Keshav, Rachna Kaul
January-March 2012, 1(1):6-12
DOI:10.4103/2278-0513.95012  
Innovation in the last decade has endowed nanotechnology with an assortment of tools for delivery, imaging, and sensing in cancer research. Cancer nanotherapeutics are rapidly progressing and are being implemented to solve several limitations of conventional drug delivery systems such as nonspecific biodistribution and targeting, lack of water solubility, poor oral bioavailability, and low therapeutic indices. To improve the biodistribution of cancer drugs, nanoparticles have been designed for optimal size and surface characteristics to increase their circulation time in the bloodstream. Nanoparticles have the ability to accumulate in cells without being recognized by P-glycoprotein, one of themainmediators of multidrug resistance, resulting in the increased intracellular concentration of drugs. Multifunctional and multiplex nanoparticles are now being actively investigated and are on the horizon as the next generation of nanoparticles, facilitating personalized and tailored cancer treatment.
  3,076 323 1
ORIGINAL ARTICLES
Feasibility of Simultaneous Integrated Boost Intensity Modulated Radiotherapy treatment plans in patients with localized carcinoma prostate
Anshuma Bansal, Rakesh Kapoor, Narendra Kumar, Arun S Oinam, Suresh C Sharma
October-December 2012, 1(4):206-211
DOI:10.4103/2278-0513.106258  
Aim: To dosimeterically analyze Simultaneous Integrated Boost Intensity Modulated Radiotherapy (SIB-IMRT) treatment plan in prostate cancer patients, in terms of target coverage and dose to organs at risk. To determine radiobiological effect of this technique on target and normal tissues using Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP). Materials and Methods: Twenty patients with localized prostate cancer were enrolled. In all, the target consisted of PTV P + SV (Prostate and seminal vesicles) and PTV LN (lymph nodes) where PTV refers to planning target volume and the critical structures included: bladder, rectum, small bowel, penile bulb and bilateral femoral heads. For all patients, SIB IMRT plan was created. The prescription dose to the PTV P + SV is 74 Gy delivered in 27 fractions over 5.5 weeks and the dose to PTV LN is 54 Gy delivered in 27 fractions over 5.5 weeks. The treatment plan was analyzed in terms of their dose-volume histograms, target volume covered by 95% of the prescription dose (V 95%), and maximum and mean structure doses (Dmax and Dmean). Also an analysis was done on TCP and NTCP obtained with the plan. NTCP was calculated by Lyman Kutcher Burman (LKB) model. Results: All the critical structures received doses within the dose constraints specified for the SIB IMRT plan. The volume of rectum and bladder receiving 65 Gy or more (V > 65 Gy) was 18.23% and 24.05%. The mean doses to both bladder and rectum were 59 ± 3 Gy and 57 ± 4 Gy respectively. NTCP of 0.01 ± 0.02% for bladder, 4.31 ± 2.61% for rectum and 8.25 ± 7.98% for small bowel was achieved with SIB-IMRT plans. Conclusions: SIB-IMRT is dosimetrically and radiobiologically feasible treatment technique for prostate cancer IMRT.
  3,213 184 -
CASE REPORTS
Long term survival in paratesticular rhabdomyosarcoma
Ritesh Kumar, Shreekant Bharti, Divya Khosla, Rakesh Kapoor
January-March 2012, 1(1):31-32
DOI:10.4103/2278-0513.95017  
Paratesticular rhabdomyosarcoma (RMS) is a rare tumor arising from the mesenchymal tissues of the spermatic cord, epididymis, testis and testicular tunics. It represents only 7% of all patients entered in the Intergroup Rhabdomyosarcoma Study (IRS) and 17% of all malignant intrascrotal tumors in children less than 15 years old. We report a case of a 13-year-old male with left paratesticular RMS who was treated successfully with surgery and systemic chemotherapy. The patient is disease-free after 7 years of treatment completion.
  3,206 170 -
Diagnostic significance of Peutz-Jeghers syndrome: A case report with oral physician's perspective
Divya Ananda, Natarajan Kannan, Rajendra Patil, Venkata Sarath, Jayaprakash S Gadagi
April-June 2012, 1(2):74-76
DOI:10.4103/2278-0513.99567  
Peutz-Jeghers syndrome is a genetic disorder characterized by intestinal polyposis and pigmentation of skin and mucous membrane. Gastrointestinal polyps are considered as premalignant and also the occurrence of rare malignancies at nongastrointestinal sites is high in these patients. This article demonstrates the importance of oral physician in the diagnosis of this inherited syndrome, thereby minimizing the morbidity in a young male patient who presented with multifocal pigmentation.
  3,091 166 -
Villoglandular papillary adenocarcinoma of cervix: A prognostic dilemma
Divya Sethi, Uma Sharma, Ketan Garg, Parul Tanwar
July-September 2012, 1(3):153-155
DOI:10.4103/2278-0513.102888  
Adenocarcinomas are the second most common type of cervical cancers in women comprising 10-20% of the cases. Villoglandular papillary carcinoma is a rare histological subtype of invasive adenocarcinoma which usually afflicts young women and carries an excellent prognosis. However, additional histological subtypes mixed with villoglandular papillary adenocarcinoma are very common; therefore, a careful inspection of the specimen should be undertaken and only if it is an exclusive or almost exclusive pattern, should a diagnosis of villoglandular papillary adenocarcinoma be made. This is because the mixed patterns do not present with the same favorable prognosis as the villoglandular adenocarcinoma; moreover, the treatment modalities would also differ. One should consider whether conservative therapy is sufficient because of the predominance of concomitance of other carcinomas besides the villoglandular papillary adenocarcinoma. We present the case of a 47-year-old lady who, on initial biopsy from cervical growth, revealed a villoglandular adenocarcinoma, but subsequent hysterectomy revealed moderately differentiated adenocarcinoma with extrauterine extension.
  3,096 139 -
"Pure" invasive apocrine carcinoma of the breast with psammoma bodies
Kavita Mardi, Shivani Sharma
January-March 2012, 1(1):37-39
DOI:10.4103/2278-0513.95020  
Pure apocrine carcinomas are rare, morphologically distinct type of invasive of breast carcinomas, and represent about 0.5% of all invasive breast cancers. Existence of psammoma bodies (PBs) is extremely rare. Cytological, histological and immunohistochemical features of a case of apocrine carcinoma of the breast with PBs is described in a 56-year-old female. This report emphasizes the rarity of this lesion and supports currently held beliefs about the formation of PBs.
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ORIGINAL ARTICLES
Diagnoses of breast masses with ultrasonography and elastography: A comparative study
Md. Sohaib Akhtar, Tariq Mansoor, Rabeya Basari, Ibne Ahmad
October-December 2013, 2(4):311-318
DOI:10.4103/2278-0513.121525  
Context : Non-invasive diagnoses of breast masses remain a challenge to the clinician. Elastography, a new modality using elastic property of breast tissue can effectively differentiate between malignant and benign breast masses minimizing the need for aggressive unnecessary biopsy. Aim: The aim is to evaluate elastography to ascertain whether the differentiation and characterization of benign and malignant breast lumps could be done with it, comparing with the conventional sonography. Settings and Design : Single institutional prospective study. Materials and Methods: The study was conducted on 82 patients with palpable breast lumps. All these cases were subjected to a thorough clinical examination, sonography, elastography, and pathological diagnosis. Results of sonography and elastography were compared considering the pathological diagnosis as standard. Statistical Analysis : Statistical analysis was performed with the McNemar test. All data analysis was conducted using SPSS software (SPSS Inc.). Results: It was observed that the USG diagnosis of carcinoma tallied with the pathological diagnosis in only 88.9% of cases (i.e. 48 out of 54 cases) and the elastographic diagnosis of carcinoma tallied with the pathological diagnosis in 96.3% (i.e. 52 out of 54). On the other hand, out of 34 and 30 cases diagnosed as benign lesions on USG and elastography, respectively, only 28 cases were proved to be benign pathologically. Conclusion: Elastography was found to be more sensitive, specific, and accurate than sonography.
  3,000 113 1
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