53 research outputs found
A unique RET EXON 11 (G691S) polymorphism in an Indian patient with a collision tumor of the thyroid
BACKGROUND: Collision tumors of the thyroid are rare, with occasional reports dealing with their genetic analysis. CASE PRESENTATION: A 59 year old lady presented with a neck mass, associated with hoarseness of voice of 5 years duration. Radiological examination revealed nodular masses in the left lobe of her thyroid, along with one in the isthmus, extending into the right lobe and associated with enlarged neck nodes. FNAC from the left thyroid showed features of medullary carcinoma. On total thyroidectomy, 2 distinct tumor nodules were identified in the left lobe with another in the isthmus, showing features of medullary carcinoma (MTC), papillary carcinoma and follicular variant of papillary carcinoma, respectively, accompanied with nodal metastasis. Subsequently, she underwent radioablation. RET gene analysis of the patient, her 2 daughters and a grandson revealed a unique G691S polymorphism on Exon 11. CONCLUSION: This unique case of a collision tumor of thyroid, including component of an MTC deals with the value of RET gene analysis and therapeutic implications in the index case and in family members
Prospective subjective evaluation of swallowing function and dietary pattern in head and neck cancers treated with concomitant chemo-radiation
Aim : Prospective subjective evaluation of swallowing function and
dietary pattern in locally advanced head and neck cancer patients
treated with concomitant chemo-radiotherapy (CRT). Materials and
Methods : Prospective evaluation of swallowing function with
performance status scale for head and neck cancer patients (PSSHN) at
pre-CRT, CRT completion and at subsequent follow-ups in adult with
loco-regionally advanced head and neck squamous cell carcinoma (HNSCC)
patients. Results : In 47 patients (40 male, seven females; mean age
53; 72% smoker 53%, oropharyngeal cancer), the mean total PSSHN score
at pre-CRT was 258.5 and decreased to 225.2 and 219.2 at two and six
months respectively. Understandability of speech, normalcy in diet and
eating in public at pre-CRT and six months were 91.5 and 84.4; 80.4 and
63.1; 87.3 and 76.6 respectively. In univariate analysis, pre-CRT PSSHN
scores were significantly lesser in patients with severe pre-CRT
dysphagia (P = 0.001), hypopharyngeal cancer (P = 0.244) and advanced
T-stage (T3/4) disease (P = 0.144). At CRT completion, there was
significant reduction of PSSHN scores in patients with severe pre-CRT
dysphagia (P = 0.008), post-CRT weight loss (>10%) and disease
progression (P = 0.039). At two months and six months, 17 (57%) and 11
(73.5%) patients respectively showed change in dietary habit. Mean
increase in meal time was 13% and 21% at two and six-month follow-up.
Conclusions : HNSCC patients show deterioration in swallowing function
after CRT with normalcy of diet in maximum and eating in public least
affected. Pre-CRT severity of dysphagia, weight loss> 10% and
disease progression have significant correlation with higher swallowing
function deterioration after CRT
Fascin overexpression promotes neoplastic progression in oral squamous cell carcinoma
<p>Abstract</p> <p>Background</p> <p>Fascin is a globular actin cross-linking protein, which plays a major role in forming parallel actin bundles in cell protrusions and is found to be associated with tumor cell invasion and metastasis in various type of cancers including oral squamous cell carcinoma (OSCC). Previously, we have demonstrated that fascin regulates actin polymerization and thereby promotes cell motility in K8-depleted OSCC cells. In the present study we have investigated the role of fascin in tumor progression of OSCC.</p> <p>Methods</p> <p>To understand the role of fascin in OSCC development and/or progression, fascin was overexpressed along with vector control in OSCC derived cells AW13516. The phenotype was studied using wound healing, Boyden chamber, cell adhesion, Hanging drop, soft agar and tumorigenicity assays. Further, fascin expression was examined in human OSCC samples (N = 131) using immunohistochemistry and level of its expression was correlated with clinico-pathological parameters of the patients.</p> <p>Results</p> <p>Fascin overexpression in OSCC derived cells led to significant increase in cell migration, cell invasion and MMP-2 activity. In addition these cells demonstrated increased levels of phosphorylated AKT, ERK1/2 and JNK1/2. Our in vitro results were consistent with correlative studies of fascin expression with the clinico-pathological parameters of the OSCC patients. Fascin expression in OSCC showed statistically significant correlation with increased tumor stage (<it>P </it>= 0.041), increased lymph node metastasis (<it>P </it>= 0.001), less differentiation (<it>P </it>= 0.005), increased recurrence (<it>P </it>= 0.038) and shorter survival (<it>P </it>= 0.004) of the patients.</p> <p>Conclusion</p> <p>In conclusion, our results indicate that fascin promotes tumor progression and activates AKT and MAPK pathways in OSCC-derived cells. Further, our correlative studies of fascin expression in OSCC with clinico-pathological parameters of the patients indicate that fascin may prove to be useful in prognostication and treatment of OSCC.</p
Hypercalcemia and Treated Breast Cancers: The Diagnostic Dilemma
The relationship of hypercalcemia with cancer is well described in the
literature. Breast cancer is the commonest malignancy associated with
hypercalcemia; the detection of hypercalcemia in these patients usually
signifies metastatic disease and is associated with a poor prognosis.
However, the treating oncologist should keep in mind that a strong
correlation exists between breast cancer and primary
hyperparathyroidism. We present a case of a patient of treated breast
cancer who, in the absence of metastatic bone disease, developed
hypercalcemia due to hyperparathyroidism secondary to a parathyroid
adenoma
Original Article - Squamous cell carcinoma of the maxillary sinus: A Tata Memorial Hospital experience
Background: The optimal treatment of maxillary sinus carcinoma remains
to be defined and there is a paucity of Indian studies on the subject.
Aims: To present experience of management of squamous cell carcinoma
of the maxillary sinus treated with curative intent at a single
institution. Settings and Design:Retrospective study of patients with
squamous cell carcinoma of the maxillary sinus who presented between
1994 to 1999. Materials and Methods:The records of 73 patients with
squamous cell carcinoma of the maxillary sinus were analyzed. Sixty-two
patients were evaluable. Forty patients (65%) were treated with surgery
followed by postoperative radiotherapy, five patients (8%) were treated
with radiotherapy alone, five patients (8%) were treated with surgery
alone; 12 patients (19%) received chemotherapy. Statistical analysis
used: Statistical analysis was done using Kaplan-Meier method.
Results: The majority of patients presented with locally advanced
disease (52, 84%); nodal involvement was observed in five patients
(8%). The most common site of recurrence was at the primary site, which
was observed in 28 patients (45%) and regional failures occurred in 10
(16%). The 3 and 5-year overall survival was 38% and 35% and the
disease free survival was 29% and 26% respectively. The 5-year overall
survival after surgery and postoperative radiotherapy was 42%.
Conclusions:The majority of patients present with advanced disease
resulting in poor outcomes to conventional treatment modalities.
Locoregional tumor progression remains a significant pattern of
failure. New approaches such as neoadjuvant or concomitant
chemoradiotherapy with aggressive surgery need to be considered and
evaluated in prospective studies
A clinical survey of laryngectomy patients to detect presence of the false perception of an intact larynx or the "phantom larynx" phenomenon
Does Diagnostic Lignocaine Block Have a Therapeutic Value in Treatment of Hypertonic Pharyngoesophageal Segment?
A unique RET EXON 11 (G691S) polymorphism in an Indian patient with a collision tumor of the thyroid
Abstract Background Collision tumors of the thyroid are rare, with occasional reports dealing with their genetic analysis. Case presentation A 59 year old lady presented with a neck mass, associated with hoarseness of voice of 5 years duration. Radiological examination revealed nodular masses in the left lobe of her thyroid, along with one in the isthmus, extending into the right lobe and associated with enlarged neck nodes. FNAC from the left thyroid showed features of medullary carcinoma. On total thyroidectomy, 2 distinct tumor nodules were identified in the left lobe with another in the isthmus, showing features of medullary carcinoma (MTC), papillary carcinoma and follicular variant of papillary carcinoma, respectively, accompanied with nodal metastasis. Subsequently, she underwent radioablation. RET gene analysis of the patient, her 2 daughters and a grandson revealed a unique G691S polymorphism on Exon 11. Conclusion This unique case of a collision tumor of thyroid, including component of an MTC deals with the value of RET gene analysis and therapeutic implications in the index case and in family members.</p
Does tranexamic acid reduce blood loss during head and neck cancer surgery?
Background and Aims: Transfusion of blood and blood products poses several hazards. Antifibrinolytic agents are used to reduce perioperative blood loss. We decided to assess the effect of tranexamic acid (TA) on blood loss and the need for transfusion in head and neck cancer surgery. Methods: After Institutional Review Board approval, 240 patients undergoing supramajor head and neck cancer surgeries were prospectively randomised to either TA (10 mg/kg) group or placebo (P) group. After induction, the drug was infused by the anaesthesiologist, who was blinded to allocation, over 20 min. The dose was repeated every 3 h. Perioperative (up to 24 h) blood loss, need for transfusion and fluid therapy was recorded. Thromboelastography (TEG) was performed at fixed intervals in the first 100 patients. Patients were watched for post-operative complications. Results: Two hundred and nineteen records were evaluable. We found no difference in intraoperative blood loss (TA - 750 [600–1000] ml vs. P - 780 [150–2600] ml, P = 0.22). Post-operative blood loss was significantly more in the placebo group at 24 h (P - 200 [120–250] ml vs. TA - 250 [50–1050] ml, P = 0.009), but this did not result in higher number of patients needing transfusions (TA - 22/108 and P - 27/111 patients, P = 0.51). TEG revealed faster clot formation and minimal fibrinolysis. Two patients died of causes unrelated to study drug. Incidence of wound complications and deep venous thrombosis was similar. Conclusion: In head and neck cancer surgery, TA did not reduce intraoperative blood loss or need for transfusions. Perioperative TEG variables were similar. This may be attributed to pre-existing hypercoagulable state and minimal fibrinolysis in cancer patients
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