7 research outputs found
The carcinoma of parathyroid gland
Parathyroid carcinoma constitutes less than 1% of primary
hyperparathyroidism. The exact etiology is not known. Prior radiation
to neck, chronic renal failure and genetic factors are thought to play
a role. The male to female ratio is one. Parathyroid carcinomas are
slow growing, have a tendency to recur locally and metastasize late.
95% of parathyroid carcinomas are functioning. The major distinguishing
features of malignant hyperparathyroidism are presence of a palpable
mass in the neck and features of severe hypercalcemia. By far the most
important test to diagnose primary hyperparathyroidism is serum level
of Immunoreactive PTH. The diagnosis of primary hyperparathyroidism is
essentially clinical and biochemical. Biopsy is not necessary before
definitive surgery. CT scan appears to be the best investigation for
detecting the primary tumor, its local extent and metastases. Most of
the symptoms are attributable to hypercalcemia, which needs to be
treated aggressively. Early surgery with 'en bloc' resection of the
tumor is the only potentially curative treatment. Parathyroid carcinoma
is traditionally said to be resistant to radiotherapy. Various
chemotherapeutic agents have been used with partial anecdotal
responses. The 5-year survival is about 50% and 10-year survival varies
from 13-49%
Retro-peritoneal plasmacytoma: A case report and review of literature
Solitary Extramedullary Plasmacytoma (EMP) is an uncommon neoplasm.
When diagnosed, head and neck region is its most likely location.
Rarely, it may occur in the retro-peritoneum. We report a 44year old
man with solitary extramedullary plasmacytoma in the retro peritoneum
(RPEMP). The patient did not show response to three cycles of VAD
chemotherapy. Thereafter Surgical excision of the mass was performed
successfully. This is probably the first case report from Indian
subcontinent
Isolated testicular relapse in acute lymphoblastic leukemia - Effective treatment with the modified CCG-112 protocol
BACKGROUND: The testes have been considered a sanctuary site for
leukemic cells and testicular relapses used to account for a major
proportion of the poor outcome of boys with acute lymphoblastic
leukemia. With use of aggressive chemotherapy which includes
intermediate or high dose methotrexate, the incidence of testicular
relapses has declined. However once these patients have received
cranial irradiation as a part of the front line protocol, high dose
methotrexate needs to be avoided because of risk of developing
leucoencephalopathy. AIM: To study the use of non cross resistant
chemotherapeutic agents along with a regimen containing lower doses of
methotrexate in patients of isolated testicular relapse (ITR).
MATERIALS AND METHODS: This is a retrospective analysis of 12
consecutive patients with ITR treated with modified version of the
CCG-112 protocol which consists of intensive systemic chemotherapy,
cranial chemoprophylaxis along with testicular irradiation. RESULTS:
One patient died of regimen related toxicity. Two patients relapsed in
the bone marrow during maintenance. Of the nine patients who completed
treatment, eight are alive and in remission. One patient had a bone
marrow relapse two months after completing treatment. The Kaplan Meier
estimates give us an Event Free Survival (EFS) of 66.7% at 10 yrs.
CONCLUSIONS: Thus, though the incidence is very low, patients with ITR
should be treated aggressively since they have an excellent chance of
achieving a long term EFS
Isolated testicular relapse in acute lymphoblastic leukemia - Effective treatment with the modified CCG-112 protocol
BACKGROUND: The testes have been considered a sanctuary site for
leukemic cells and testicular relapses used to account for a major
proportion of the poor outcome of boys with acute lymphoblastic
leukemia. With use of aggressive chemotherapy which includes
intermediate or high dose methotrexate, the incidence of testicular
relapses has declined. However once these patients have received
cranial irradiation as a part of the front line protocol, high dose
methotrexate needs to be avoided because of risk of developing
leucoencephalopathy. AIM: To study the use of non cross resistant
chemotherapeutic agents along with a regimen containing lower doses of
methotrexate in patients of isolated testicular relapse (ITR).
MATERIALS AND METHODS: This is a retrospective analysis of 12
consecutive patients with ITR treated with modified version of the
CCG-112 protocol which consists of intensive systemic chemotherapy,
cranial chemoprophylaxis along with testicular irradiation. RESULTS:
One patient died of regimen related toxicity. Two patients relapsed in
the bone marrow during maintenance. Of the nine patients who completed
treatment, eight are alive and in remission. One patient had a bone
marrow relapse two months after completing treatment. The Kaplan Meier
estimates give us an Event Free Survival (EFS) of 66.7% at 10 yrs.
CONCLUSIONS: Thus, though the incidence is very low, patients with ITR
should be treated aggressively since they have an excellent chance of
achieving a long term EFS