Information: A Priceless Gift in Chronic Care Management of Cancer Patients

The search for true information is a distressing andanxious provoking situation for patients diagnosed with cancer.Health professionals who are in possession of valuableinformation should learn to disseminate information usingprofessional principles to enhance the coping among cancerpatients. The art of communicating health information is adifficult task, but learning to do this unpleasant but necessarytask, can go a long way in enhancing the quality of life amongcancer patients and in many ways is an enriching experience.The purpose of the study was to review and delineate theinformational needs of cancer patients from the perspectives ofthe cancer patients, their significant others, health professionals(doctors & professional nurses) and members of thecommunity. Design: of the study was descriptive. Data wascollected using a structured interviews tool, adapted from theToronto Informational Needs Questionnaire for Breast Cancer(TINQ-BC) and the Informational Needs AssessmentQuestionnaire for men with prostate cancer. The subscalesinvestigated were disease, investment test, treatment, physicaland psychosocial concerns. The sample size was 150 whichwas distributes as 30 from each category of variables.Results: The results showed that there were significantdifferences in the perceptions of variables with regard to theinformational needs of cancer patients. This was furtheranalyzed using chi-square test. A major theme which evolvedacross the interaction with cancer patients reflected oncommunication as a critical element in providing care andsupporting self-care management. The findings enlarge uponpatient-centered approaches to health care communication.Based on these core concepts, a set of guidelines which focuseson feelings of team work and self-direction was formulated todisseminate information to cancer patients

Tuberculous osteomyelitis of the scapula masquerading as metastasis

Tuberculosis (TB) of the scapula is an unusual presentation of musculoskeletal tuberculosis. In an endemic area, this rare presentation may become more frequent. The indolent nature of tuberculous bone and joint disease often leads to delayed or missed diagnosis. It is not uncommon for this disease to mimic malignancy. Therefore, the prompt recognition of distinguishing features is vital for correct diagnosis. In particular, imaging is a key tool in helping to make the diagnosis, through the recognition of certain key radiological patterns. However, as there are no pathognomonic imaging findings, the diagnosis rests on histopathological and microbiological confirmation. We report a case of tuberculous osteomyelitis of the scapula. This entity has not received much attention in literature. Pure tuberculous osteomyelitis involving flat membranous bone, as depicted in this report, is rare. Our patient also had an ovarian malignancy, which had decreased our index of suspicion. We therefore present this case as tuberculosis masquerading a cystic scapular metastases

Malignancy and autoimmunity : causally or casually related?

Coexistent malignancy and autoimmune rheumatic disease requires the physician to explore a causal link. Rheumatic manifestations mimicking autoimmune diseases can precede, accompany or follow the onset of neoplastic disease. Identified links include shared environmental factors such as smoking with rheumatoid arthritis and lung cancer, and a common disease such as inflammatory bowel disease with spondyloarthritis and colon cancer. Long-term and often severe immune stimulus of autoimmune disease has been linked to malignancy of the immune system, and paradoxically, long-term suppression of the immune response as exemplified in organ transplantation, is also linked to risk of subsequent malignancy

Cutaneous metastasis from testicular germ cell tumour

The skin is an unusual site of metastases from solid organ malignancies. We report the case of a patient with a malignant mixed non-seminomatous germ cell tumor of the testis, presenting with cutaneous metastasis, which was treated with salvage chemotherapy

Malignant melanocytic neoplasm of pancreas with liver metastasis: Is it malignant melanoma or clear cell sarcoma?

Malignant melanocytic neoplasm, usually seen in soft tissues, is rare in a visceral location and presents as a diagnostic dilemma. We present a case of pancreatic malignant melanocytic neoplasm with liver metastasis. A 58-year-old man presented with left upper abdominal swelling and loss of appetite. Imaging revealed a large mass arising from the pancreatic tail, and this was diagnosed as malignant neoplasm with melanocytic differentiation on biopsy with the possible differentials of malignant melanoma, clear cell sarcoma (CCS), and perivascular epithelioid cell neoplasm. The patient underwent distal pancreatectomy and splenectomy for the same. Follow-up imaging 6 months later showed a metastatic liver lesion, for which he also underwent a liver resection. BRAF mutational analysis was found to be negative. Both CCS and malignant melanoma have similar morphological features and melanocytic differentiation, but each harbors a distinct genetic background. Differentiation of both has diagnostic and therapeutic implications

Clinical course of disseminated Kaposi sarcoma in a HIV and hepatitis B co-infected heterosexual male

AIDS associated Kaposi sarcoma (AIDS-KS) was first reported from India in 1993. Since then only 16 cases have been reported. Three of them had proven Human Herpesvirus 8 (HHV-8) infection. We report a case of disseminated KS in a heterosexual male from India with HIV, hepatitis B and HHV-8 infection. He was given six cycles of chemotherapy with liposomal doxorubicin over three months to which he showed a good response. The case highlights the clinical course and management of a HHV-8 positive disseminated KS in a patient co-infected with Hepatitis B and HIV