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   Table of Contents - Current issue
May-August 2019
Volume 3 | Issue 2
Page Nos. 25-49

Online since Wednesday, September 18, 2019

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Role of fertility-sparing surgery in gynecological malignancy p. 25
Priyanka Priyadarshini
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Clinical dosimetric impact of AAA and Acuros XB on high-density metallic implants in case of carcinoma cervix p. 28
Manindra Bhushan, Girigesh Yadav, Deepak Tripathi, Lalit Kumar, Vimal Kishore, Rahul Lal Chowdhary, Gourav Kumar, Soumya Datta, Swarupa Mitra, Munish Gairola
Background: Metallic implant in radiotherapy leads to difficulty in tumor target and critical organ delineation. Four-field box technique is conventional approach to treat pelvic malignancies. Aim of the Study: The aim of study is to evaluate the dosimetric impact of calculation algorithms in the treatment of carcinoma cervix with metallic implants. Materials and Methods: A paraffin wax-coated iron rod was used to evaluate the beam characteristics under the influence of metallic implant. Beam characteristics such as tissue phantom ratio (TPR20,10) were measured and analyzed. 15 patients with and without metallic prosthesis of carcinoma cervix were compared in the study. Planning was done for the prescription dose of 45 Gy/25 fractions. Plans were calculated using AAA algorithm and recalculated using Acuros XB (AXB) and pencil beam convolution algorithms for the same monitor units. RTOG and Quantec Protocol were used for plan evaluation. Results: Transmission and TPR20,10increases with field size and beam energy. Surface dose Dsalso increases with field size. D98%and D2%of planning target volume showed a significant difference for AAA versus AXB. 4FN (AAA) are significantly better for all the 4F plans, calculated by three algorithms in case of V15Gyof small bowel. Analyzed data indicated the significant attenuation caused by high-Z material. Analyzed value of conformity index showed that value of index comes >1 in all the cases. Conclusion: The results indicate that when creating treatment plans for cervical cancer lesions with metallic prosthesis, the AAA algorithm would be a more appropriate choice.
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Hidradenoma papilliferum of the vulva with extensive squamous metaplasia mimicking malignancy: Rare entity with diagnostic challenge p. 38
Dhaval Jetly, Ritwika Dabral, Deepak Goel
Hidradenoma papilliferum (HP) is an uncommon benign cutaneous adnexal neoplasm of the anogenital region commonly seen in middle-aged, Caucasian females. Anastomosing and branching tubules, lined by columnar cells, and a basal layer of myoepithelial cells are the characteristic histopathological features. We report a case of HP in a 60-year-old female presented with a vulvar lesion. The case was evaluated for malignancy, with the initial histopathology showing extensive squamous metaplasia but ultimately found to have HP.
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Carcinosarcoma of ovary with long-term overall survival p. 41
Priyanka Priyadarshini, Saroj Kumar Das Majumdar, Dillip Kumar Parida
Carcinosarcoma or mixed Müllerian malignant tumors are a rare entity representing 1% of all the malignant ovarian neoplasms. It has poor prognosis, and the survival outcome is worst. We report a case of carcinosarcoma of the ovary in a 68-year-old female. The patient was treated with cytoreductive surgery followed by platinum- and taxane-based combination chemotherapy regimen. Now, the patient is under regular follow-up with long-term overall survival for 76 months without any disease. Therefore, our case highlights the importance of cytoreductive surgery followed by adjuvant chemotherapy with platinum- and taxane-based combination regimen in the form of improved survival demanding a long-term follow-up for such cases.
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Sporadic synchronous triple primary cancers in elderly female: Microsatellite instability high resectable colon cancer, epidermal growth factor receptor-mutated metastatic lung cancer, and neuroendocrine tumor of appendix p. 45
Sumit Goyal, Sneha Botra, Manish Sharma, Manoj Gupta, Venkata Pradeep Babu Koyyala, Ankush Jajodia, Pradosh Kumar Sarangi
Colorectal cancer and lung cancer are the most common malignancies in the world. However, not all pulmonary nodules in a case of colon cancer are considered as metastasis, especially with features suggestive of limited colon disease without any nodal or liver involvement. The morphology of the pulmonary nodules is also an important consideration before subjecting the patient to another invasive procedure, as solitary pulmonary nodule with irregular margins, suggestive of another primary lesion. We describe a case of a patient with colon cancer, nonsmall cell lung cancer with single bone lesion, and neuroendocrine tumor of appendix. Initially suspected to be a case of metastatic colon cancer, the patient was later diagnosed as epidermal growth factor receptor-mutant metastatic pulmonary adenocarcinoma, with localized microsatellite instability high phenotype colon cancer.
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Cell block: A boon in the world of cytology! p. 48
Sonali Susmita Nayak
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