Pattern of neck metastasis in carcinoma of oral tongue-a prospective study of north eastern people

Background: North eastern part of India is one of the most vulnerable regions for all sites of cancer. There is various literature regarding the pattern of cervical metastasis from different sub sites of oral cavity, however there are very few studies from the north eastern part of India, which reports one of the world highest number of cases. The aim and objectives of this study were to study the pattern of cervical lymph node metastasis in relation to prognostic factor like histological grading, laterality, depth of invasion, lymphovascular and perineural invasion and worst pattern of invasion.Methods: A prospective study of 20 patients who had undergone surgery for carcinoma of oral tongue was conducted in State cancer institute in department of Head and neck oncology from January 2020 till June 2021. Out of 20 patients included in the study 6 (30%) were females and 14 (70%) were males. Results: Clinically 9 patients had palpable nodes but pathologically nodes were positive in 10 patients whereas when a node was clinically not palpable in 11 patients, patients was pathologically nodes negative only in 10 patients.2 patients had isolated II involvement. 1 patient has I(b) and level II involvement. 4 patients had level II and III together. Two patients had level II and level IV involvement. 1 patient had level I(A), I(B), III and IV involvement. None of the patient had level 5 involvements.Conclusions: DOI, WPOI and tumor differentiation are the important prognostic parameters. We would also like to suggest surgical excision of the tumor and measurement of WPOI, DOI and assessment of histological grading to be done from frozen section for determining the type of neck dissection in T1/T2 N0 cases

Chromobalstomycosis - A clinical mimic of squamous carcinoma

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue caused by dematiaceous fungi. We report a case of chromoblastomycosis caused by Fonsecaea pedrosoi from a subtropical region of India that developed over the left foot of a 45-year-old male farmer and was provisionally diagnosed as squamous cell carcinoma. The patient presented with irregular warty growths over the left foot, which had started one year previously, and has gradually progressed over a year to involve the lateral aspect of left leg. The diagnosis of chromoblastomycosis was confirmed by histopathology and fungal culture

Vascular leiomyosarcoma of thigh - a rare tumour at an unusual site

Leiomyosarcomas of vascular origin are rare. They originate from the smooth muscles of tunica media of major blood vessels. The majority of such tumours arising in the extremities affect the femoral vascular bundle. There is limited knowledge and experience of the clinical presentation, pathological reports and results of treatment of this type of tumour. A case of primary leiomyosarcoma of femoral vein is being reported from a subtropical region of India that developed over the right thigh of a 35-year-old male farmer and was clinically diagnosed as benign soft tissue tumour. The diagnosis was confirmed by histopathology and immunohistochemistry

Relationship of depth of invasion of tumour with neck node metastasis in oral squamous cell carcinoma: a clinico pathological correlation

Background: Squamous cell carcinomas of the oral cavity are relatively common among the head and neck cancers. The increasing depth of invasion (DOI) and the microvascular proliferation caused by neoplastic growth might determine proximity to blood vessels and lymphatics, thus facilitating the tumor’s ability to metastasize. The role of tumour DOI as a prognostic parameter for the development of nodal metastases and for the survival of patients with OSCC are important. Aim of the study was to determine the relationship of the DOI of tumor with the neck node metastasis in squamous cell carcinoma of the oral cavity.Methods: This study is conducted in the State cancer institute, Gauhati medical college over a period of 1 year from June 2021 to June 2022 among 100 patients. All patients underwent tumor resection with neck dissection, and the DOI is measured.Results: Out of 100 patients included in the study 66 were males and 34 were females. Maximum number of cases 30% were seen in the age group of 51-60 years. Gingivobuccal sulcus (32%) is the most commonly involved site. Maximum number of nodal meta-stasis present in tumours with DOI>11 mm and minimum nodal metastasis present in tumours with DOI<3 mm.   Conclusions: We conclude that tumor DOI is significantly related with neck nodal metastasis in oral cavity squamous cell carcinoma

Myxoma of parotid gland: report of a rare case

Myxomas of head and neck and especially parotid gland are rare. These insidious soft tissue tumours have obscured pathogenesis, can occur at any age, mostly located in the cheek, palate or floor of mouth. They often present with non- specific symptoms like painless slow growing localised swelling in the cheek or around the jaw. Complete excision remains the mainstay of treatment with rare recurrence, no distant metastases and excellent prognosis. Here we reported a case of right sided parotid gland myxoma in a 37 years old man. There were no specific clinical, laboratory or radiological features. Fine needle aspiration cytology was reported as adenoid cystic carcinoma of right parotid gland. Histopathological examination of the specimen confirmed the diagnosis of myxoma. Immunohistochemistry can be helpful, but not necessary to come to a diagnosis

Carcinosarcoma of the vulva: a rare case report

Carcinosarcomas are rare and clinically aggressive neoplasms with poor outcome. A very few cases has been reported in the literature. We present a case of a 54 yrs woman with bleeding per vagina for 1.5 months. On per vaginal examination, a lump of size 3×2 cm was found over the left anterior region of vulva. CECT abdomen revealed a well-defined heterogeneously enhancing lesion with calcific foci involving both labia minora. MRI pelvis reveals carcinoma left vulva with involvement of lower 3rd of vaginal wall. Histopathological examination showed features suggestive of carcinosarcoma of the vulva. This was further confirmed by immunohistochemistry which showed positivity for CK, SMA, caldesmon and negative for S100, CD34, desmin, CD31, ERG and MyoD1. Because it is a very rare tumor with severe prognosis, we presented this case as this case report can be a useful addition to the literature.

Oral squamous cell carcinoma with clear cell change: a rare case report

Clear-cell variant of oral squamous cell carcinoma is an extremely rare entity. Clear-cell change can be seen in any of the neoplasms, but as pure form variant, it is difficult to find in head-and-neck SCC. We hereby present a case report of 71-year-old male who presented with a growth with erythematous patches on the lateral pharyngeal wall for the past 3 months. Histopathologic examination showed nests, islands and sheets of malignant squamous cells with vesicular nuclei and abundant clear cytoplasm. Neoplastic cells constituting majority of nests exhibited clear cell changes. Special stain was performed to identify the nature of clear cells. periodic acid Schiff-diastase (PAS-D) showed positivity in the clear cells. Immunohistochemical study using antibody for pan-cytokeratin revealed diffuse positivity in the tumor cells

Sinonasal teratocarcinosarcoma: a rare case report from a tertiary care centre of North East India

Sinonasal teratocarcinosarcoma is an extremely rare malignant tumour arising in the sinonasal tract, that may extend intracranially to complicate the treatment and further worsen its dismal prognosis. Diagnosis is challenging because of its rarity and morphologic heterogeneity. Here, we reported a case of a 55 years old male who presented with complaints of left sided nasal blockage and facial swelling. CECT showed a large sinonasal mass with epicentre in the left nasal cavity extending to post nasal space and nasopharynx, eroding the left medial orbital wall and cranially the cribriform plate. Histopathologically, malignant epithelial component comprising of squamous cell carcinoma, mesenchymal component comprising of fibrosarcoma with focal chondroid differentiation, primitive blastemal component with extensive necrosis was noted. Immunohistochemistry demonstrated positivity for synaptophysin, chromogranin, Pan-CK, EMA, CD99, focal p63 in areas of squamous metaplasia; stromal cells showed Desmin, S100, SOX 10 expression: Ki-67 was 30-40%. Immunohistochemistry confirmed the diagnosis of sinonasal teratocarcinosarcoma. Knowledge about this tumour is important because of its heterogenous morphology which often leads to a misdiagnosis, necessitating repeated biopsies and thorough examination of the surgical specimen