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  Most popular articles (Since May 19, 2017)

 
 
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CASE REPORTS
Intraosseous lipoma of ilium: A rare case report with review of literature
Nirmal Chandra Mohapatra, Anshuman Sahoo, Jitendra Mishra, H Vinay Kumar
July-September 2017, 1(1):10-12
DOI:10.4103/oji.oji_5_17  
Intraosseous lipoma (IL) is a rare benign bone lesion, and it constitutes about 0.1% of all bone tumors. The majority of cases are located in the metaphyseal region of the long bones in the lower limbs. We report a rare case of lipoma of the ilium in a 12-year-old male child presenting with mass over the right gluteal region. Meticulous marginal dissection was done, and a pedunculated mass originating from the lower right sacroiliac region was excised in toto. The case was an atypical example of an IL with a large outgrowth involving sacroiliac region with inconclusive magnetic resonance imaging and needle biopsy findings.
  1,161 79 -
ORIGINAL ARTICLE
Comparison between crush/squash cytology and frozen section preparation in intraoperative diagnosis of central nervous system lesions
Swagatika Samal, Rajnish Kalra, Jyoti Sharma, Ishwar Singh, Devasis Panda, Megha Ralli
October-December 2017, 1(2):25-30
DOI:10.4103/oji.oji_21_17  
Aim: The aim of this study is to analyze the correlation/diagnostic accuracy of cytology and frozen section (FS) preparations in the intraoperative diagnoses of central nervous system (CNS) lesions. Materials and Methods: A total of 63 cases of CNS lesions were included in the study from July 2012 to January 2015 at a tertiary care referral hospital. Intraoperative specimens were used for crush/squash smears and FS and correlated with the final histopathological diagnosis. Results: Majority of the patients (73.02%) were presenting in the age range of 21–50 years. There was a slight female preponderance with male-to-female ratio of 1:1.1. Two out of 63 cases were excluded from the cytology correlation analysis due to inadequate materials and 3 out of 63 cases were excluded from the FS correlation analysis due to freezing artifacts. The diagnostic accuracy of cytological preparation was 80.33% for complete correlation with histopathology and was increased to 93.44% for adding the partial correlations. The corresponding figures for FS were 81.67% and 93.33%, respectively, and the difference was insignificant (P = 0.971). The sensitivity, specificity, positive predictive value, and negative predictive value in detecting neoplastic condition on cytology were 94.4%, 85.7%, 98.07%, and 66.67%, respectively, and that of FS were 96.15%, 75%, 96.15%, and 75%, respectively. The corresponding P = 0.872, 0.652, 0.986, and 0.561, respectively. Conclusion: Crush and FS preparation are considered as effective diagnostic procedures for rapid intraoperative diagnosis in CNS lesions without any significant difference in results and when applied simultaneously can produce a higher diagnostic accuracy complementing each other's results.
  1,036 119 -
Unusual histological variants and a rare bone involvement of osteosarcoma in a referral hospital
Kaumudeee Pattnaik, Pranati Pradhan, Asaranti Kar, Subrat Burma, Sasmita Panda
July-September 2017, 1(1):2-6
DOI:10.4103/oji.oji_6_17  
Aim: This study aimed to document the total number of osteosarcomas of bone diagnosed in a referral hospital differentiating from its close mimics with biologic behavior. Materials and Methods: This study analyzes the total cases diagnosed as osteosarcoma from 2014 to 2016 in the Department of Pathology, SCB Medical College, Cuttack, Odisha. Results: A total of 21 cases were diagnosed with osteosarcoma, the most common subtype being conventional osteosarcoma. This subtype constituted the majority (18 cases); the age range varied between 14 and 20 years. This article describes two rare histologic subtypes; small cell variant and giant cell-rich osteosarcoma, a rare bone involvement, like mandibular jaw bone, in an elderly female was also documented along with histologic features of each one. Conclusion: Three cases with unusual histologic subtypes and rare bone involvement, gnathic type, prompted us to report these cases.
  1,037 96 -
CASE REPORTS
Calcaneal osteosarcoma: An unusual cause of chronic pediatric heel pain
Pradosh Kumar Sarangi, Elluru Santosh Kumar, Jayashree Mohanty
October-December 2017, 1(2):31-33
DOI:10.4103/oji.oji_13_17  
Calcaneal osteosarcoma is a rare entity, which presents with chronic heel pain and swelling and often clinically misdiagnosed as a traumatic or inflammatory process. The diagnostic confusion is because of the rarity of this entity and unawareness of such rare areas of affection of osteosarcoma. This usually leads to delayed diagnosis and treatment and may severely affect the prognosis. We present a rare case of osteosarcoma involving calcaneus in a 10-year-old female who presented with long-standing left heel pain and swelling where the diagnosis of a sinister underlying bone lesion was delayed.
  1,023 77 -
Primary synovial chondromatosis of knee with both intra-articular and extra-articular involvement: A case report with delayed diagnosis
Pradosh Kumar Sarangi, T Seetam Kumar
October-December 2017, 1(2):46-48
DOI:10.4103/oji.oji_17_17  
Primary synovial chondromatosis (PSC) is an uncommon benign disease process of unknown etiology in which the synovium undergoes metaplasia, leading to cartilaginous nodules that progressively undergo detachment, mineralization, and even ossification forming loose bodies. It is usually a monoarticular disease with involvement of large joints with knee being the most common. Involvement of smaller joints such as distal radioulnar, tibiofibular, metacarpophalangeal, and metatarsophalangeal joint has also been reported. This disease process is usually intra-articular. Involvement of extra-articular tissues such as bursae and tendon sheaths is rare, and combination of intra- and extra-articular diseases described here is an extremely rare condition. Herewith, we report a male patient with PSC of left knee with involvement of suprapatellar bursa who presented with recurrent knee swelling and pain with diagnostic delay of 2 years. We have also highlighted the role of imaging in the early diagnosis of this disease and briefly reviewed relevant literature.
  979 95 -
ORIGINAL ARTICLE
Carcinoma of gall bladder: Demographic and clinicopathological profile in Indian patients
AP Dubey, Kavita Rawat, Nikhil Pathi, S Viswanath, Anvesh Rathore, Rajan Kapoor, Abhishek Pathak
January-March 2018, 2(1):3-6
DOI:10.4103/oji.oji_1_18  
Aim of the Study: The aim of this study is to evaluate the demographic and clinicopathological profile of the patients with gallbladder cancer (GBC). Materials and Methods: A total of 68 diagnosed cases of GBC were taken in the study during the study period from January 2016 to December 2017. A detail questionnaire was filled through the counseling to take demographic profile including socioeconomic status, nonclinical characteristics, dietary, and other risk factors apart from clinicopathological profile of patients. Results: We found most of the patients were females with median age 51.8 years. More than half of them were postmenopausal (56.60%), and high parity was seen in 39.62% of females. Obesity was associated factor mainly in females (28/53), and none of the males were obese. Nearly 83.82% (57/68) of patients had advanced stage disease, with metastatic disease in 72.06% (49/68) patients. Majority of the patients had at least two sites of metastasis (73.47%), with liver (57.14%), omentum (40.82%), and nonregional lymph nodes (53.06%) being common sites of dissemination. Bony metastasis, being rare in literature, was found in 6 (12.24%) of patients, most of them developed it later during the disease course. Conclusion: Majority of the patients was female within the age group of 41–60 years, associated with gallstones and had advanced disease. We did not find greater impact of diet on the incidence as vegans and nonvegans were almost equally divided in our study. A high index of suspicion and health education seems to be the only answers available for early detection and improvement of survival.
  934 121 -
EDITORIAL
Solving Cancer-related issues with a new hope
Tapan Kumar Sahoo
July-September 2017, 1(1):1-1
DOI:10.4103/oji.oji_11_17  
  892 95 -
CASE REPORTS
Acute lymphoblastic leukemia with normal platelet count
Reema Bhushan, Kiran Agarwal, Jyoti Garg
October-December 2017, 1(2):43-45
DOI:10.4103/oji.oji_14_17  
B-acute lymphoblastic leukemia (ALL) often presents as pancytopenia/bicytopenia with thrombocytopenia being very common. A 15-year-old child with high-grade fever showed bicytopenia on peripheral smear with 10% blasts. Bone marrow examination showed 65% lymphoblasts which were negative for myeloperoxidase. The blasts suppressed the erythroid population but not the megakaryocytic population. On flow cytometry, a diagnosis of common – ALL antigen-positive B – precursor ALL was given. To conclude, ALL cannot be excluded in patients who present with a normal platelet count. A bone marrow aspirate is crucial in patients with bi/pancytopenia.
  816 68 -
Malignant brenner tumor of ovary: A case report and review of literature
Rohani Nayak, Suchismita Biswal, Ashok Kumar Padhy, Janmejay Mohapatra
July-September 2017, 1(1):19-21
DOI:10.4103/oji.oji_9_17  
Brenner tumors are the rare solid ovarian tumor, malignant variant being rarer. It commonly presents with vaginal bleeding, a palpable pelvic mass, and pelvic pain. Mostly, it is unilateral with local dissemination and spreading beyond the pelvis to distant organs is rare. It closely resembles transitional cell carcinoma of urinary bladder. Optimal surgery in advanced disease and surgical staging in the early stage is the corner stone of management. We report a case of malignant Brenner tumor of the ovary in 70-year-old female treated with staging laparotomy followed by adjuvant chemotherapy and having no evidence of disease after 2 years follow-up.
  787 88 -
Microcystic adnexal carcinoma of face a rare aggressive pathology
Tribikram Debata, Punyasloka Pati, Suryanarayan Das
July-September 2017, 1(1):16-18
DOI:10.4103/oji.oji_8_17  
Microcystic adnexal carcinoma (MAC) is an uncommon, locally aggressive, malignant cutaneous tumor having pilar and eccrine differentiation and most commonly occurs in the head and neck region but rare among skin cancer. It is characterized by slow, but locally aggressive growth pattern with infiltration into surrounding structures which is characterized by a combination of keratinous cysts in the upper dermis, islands, and strands of small basaloid, benign-appearing keratinocytes or squamous cells in the deeper dermis within a dense desmoplastic stroma, and areas of ductal differentiation. We report a case of MAC of right cheek in a 50-year-old male patient with diagnostic challenges. MAC may include in the differential diagnosis list of slowly growing tumors of the face.
  808 64 -
Effect of denosumab in giant cell tumor of bone
Ramesh Chandra Maharaj, Sibasish Panigrahi, Biplabi Sarangadhar Das
October-December 2017, 1(2):34-36
DOI:10.4103/oji.oji_15_17  
Giant cell tumor (GCT) of bone is a benign tumor with locally aggressive nature. The presence of mononuclear stromal cells and multinucleated giant cells is the microscopic characteristic feature of the GCT. It is an osteoclastic tumor with destruction of tumor is mediated by the receptor activator of nuclear factor kappa-B ligand (RANKL). Denosumab, a RANKL inhibitor, may reduce or eliminate tumor giant cells, the relative content of proliferative, densely cellular tumor stromal cells, replacing with nonproliferative, differentiated woven new bone. We report a case of GCT of the right distal femur in a 20-year-old female, treated with 6 cycles of denosumab as neoadjuvant therapy, which shows consolidation of the lesion and became amenable for extended curettage with phenol cauterization and cementing without going for any radical surgery shown to have very good functional outcome.
  751 92 -
EDITORIAL
Role of immunohistochemistry in gynecological malignancies
Asaranti Kar
January-March 2018, 2(1):1-2
DOI:10.4103/oji.oji_8_18  
  741 99 -
CASE REPORTS
Metachronous squamous cell carcinoma of bilateral external auditory canals: A rare case report
Deepak Dalmia, Sanjaya Kumar Behera
July-September 2017, 1(1):13-15
DOI:10.4103/oji.oji_7_17  
Squamous cell carcinoma of the external auditory canal (EAC) is a rare and unusual entity with an incidence of 0.2% cases of all head and neck carcinomas has been reported in the literature, and even fewer describe bilateral tumors. Its clinical presentation is similar to chronic otitis media or otitis externa. Hence, the diagnosis often delayed. Early diagnosis is directly related to the prognosis of the patient. The surgical treatment is a challenging task for the experienced skull base surgeon. Here, we report a case of metachronous bilateral EAC carcinoma in a 33-year-old male. The gap between the development of left and right side carcinoma is 3 years.
  724 65 -
Clinicopathological contributions at diagnosis of bilineal extramedullary blast proliferation
Sonali Susmita Nayak, Neeraj Arora, Mayur Parihar, Indu Arun
July-September 2017, 1(1):7-9
DOI:10.4103/oji.oji_3_17  
Blast phase of chronic myelogenous leukemia (CML) presenting as extramedullary blast proliferation is seen in only 6%–10% of cases. A bilineal blast proliferation of myeloid and T-cell lymphoid lineage is even rarer. These cases usually have various additional cytogenetic clonal abnormalities along with the presence of Philadelphia chromosome (Ph chromosome) or BCR-ABL fusion gene. Considered to be an aggressive hematologic malignancy, it needs prompt initiation of chemotherapy along with Imatinib and stem cell transplant. We report here a case of bilineal extramedullary blast proliferation in a 33-year-old male presenting with an initial diagnosis of CML. Lymphoblastic lymphoma, de novo acute myeloid leukemia are considered as close differentials; absence of proper clinical findings, lack of other components of myeloid differentiation can be potential pitfalls in arriving at a correct diagnosis.
  723 63 -
EDITORIAL
Fertility issue and sperm banking among testicular cancer survivors
Tapan Kumar Sahoo
October-December 2017, 1(2):23-24
DOI:10.4103/oji.oji_19_17  
  680 88 -
CASE REPORTS
Glioblastoma multiforme in a pediatric child
Subhasis Mishra, Ashis Patnaik, Saroj Kumar Das Majumdar, Dillip Kumar Parida
April-June 2018, 2(2):38-40
DOI:10.4103/oji.oji_14_18  
Glioblastoma multiforme (GBM) is the most aggressive, malignant primary brain tumor with increasing frequency in older age group. The majority of cases occur in the 6th to 8th decade of life, with a male predominance. GBM is unusual in the pediatric age group and accounts for only 3% of all the childhood brain tumors. The treatment of GBM is still challenging in children. We report a case of GBM in an 11-year-old male child located in the right cerebral hemisphere. Right fronto-parietal craniotomy and gross total excision of the tumor were performed successfully.
  659 53 -
EDITORIAL
Liquid biopsy in oncology practice
Tapan Kumar Sahoo
July-September 2018, 2(3):45-46
DOI:10.4103/oji.oji_32_18  
  593 117 -
CASE REPORTS
Carcinoma of prostate with endobronchial and mediastinal lymph node metastasis
KO Rohit, K Praveen Valsalan, Jacob Baby, Nita John, Elizabeth Sunila, Mitchelle Lolly
April-June 2018, 2(2):32-34
DOI:10.4103/oji.oji_11_18  
Endobronchial malignancies are usually associated with bronchogenic carcinoma. About 1.1% of cases may be due to extrapulmonary source of metastasis. Only few case reports have mentioned about the carcinoma of prostate with mediastinal lymph node and endobronchial metastasis. Here, we report such a case where endobronchial lesions were removed bronchoscopically and the patient improved symptomatically. Biopsy showed the metastatic adenocarcinoma and immunohistochemistry was positive for prostate-specific antigen.
  646 61 -
Subungual glomus tumor in hand and treatment: A report of three cases
Ramesh Chandra Maharaj, Jitendra Kumar, Satish Kumar Nanda, Tapas Kumar Panigrahi
January-March 2018, 2(1):7-9
DOI:10.4103/oji.oji_6_18  
Hand pain is a common presenting symptom in orthopedic, but digital pain due to glomus tumor is a rare entity. It is a benign vascular neoplasm arising from glomus body with subungual space of nail plate of the hand being the common location. Bluish- or pinkish-red discoloration of the nail plate with classical triad of localized tenderness, severe pain, and cold sensitivity are the common presentations of the glomus tumor. Treatment is purely surgical, i.e., complete surgical excision with dramatic results. We report three cases of subungual glomus tumor in the hand, and all the cases underwent complete excision of the tumor followed by complete relief of the symptoms.
  625 74 -
ORIGINAL ARTICLE
Cytological pattern of papanicolaou smears and detection of cervical cancers: An experience from a tertiary care center of eastern zone of India
Debasmita Das, Asaranti Kar, Shreya Rath, Subrat Kumar Baliarsingh, Dibyajyoti Prusty, Akhyaya Kumar Dash
April-June 2018, 2(2):25-28
DOI:10.4103/oji.oji_15_18  
Aim of the Study: The present study attempts to explore various types of lesion of the uterine cervix and to find target age groups in which screening efforts can be concentrated for early detection of cervical cancers. Materials and Methods: The study was carried out at a tertiary care institute during the period from May 2016 to December 2017. All the previously conducted cervical Papanicolaou (Pap) smears were analyzed and reported as per the 2001 Bethesda system. The data were noted in a structured pro forma and evaluated. Results: A total of 5025 Pap smears were examined. Maximum number of patients was in the age group of 31–40 years (33.25%). Out of 5025 pap smears, 6.60% (332) of cases were found to be unsatisfactory or inadequate samples, 90.97% (4571) cases were reported as negative for intraepithelial lesion or malignancy, and 2.43% (122) cases had epithelial cell abnormality (ECA). Premalignant lesions such as: atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade intraepithelial lesion (HSIL) and atypical squamous cells-cannot exclude HSIL (ASCH), and malignant lesions such as squamous cell carcinoma and adenocarcinoma were reported under the ECA positive cases. Majority of premaligant lesions found in the age group of 41–50 years and constitute 44.64% (25/56). Whereas, majority of frank malignancy cases found in the age group of 51–60 and >60 years constituting 43.94% and 37.88%, respectively. Among all the ECA positive cases, 54.10% of cases found to be with malignancies. Conclusion: Proper implementation of Pap smear screening examination can decrease the incidence of cancer cervix along with its downstaging by early detection of precancerous lesions.
  614 80 -
EDITORIAL
Screening for early detection of cancer – Hope for cure
Tapan Kumar Sahoo
April-June 2018, 2(2):23-24
DOI:10.4103/oji.oji_19_18  
  591 94 -
ORIGINAL ARTICLES
Diagnostic utility of touch imprint cytology in the evaluation of intraabdominal tumors
Amit Kumar Adhya, Madhabananda Kar, Ranjan Mohanty
July-September 2018, 2(3):47-50
DOI:10.4103/oji.oji_25_18  
Objectives: Touch imprint cytology (TIC) of biopsy specimen can be utilized for a rapid on-site evaluation of tumors. Its usefulness for intraoperative diagnosis is well known. We evaluated the advantages and limitations of TIC of trucut biopsies of intraabdominal tumors. Materials and Methods: TIC was obtained in 42 consecutive cases of intraabdominal masses. The sensitivity, specificity, and diagnostic accuracy of TIC were evaluated by comparing it with the final biopsy diagnosis. Results: The study included retroperitoneal tumors (13 cases, 30.95%), liver mass (11 cases, 26.19%), gall bladder mass (4 cases, 9.53%), pelvic mass (3 cases, 7.14%), iliac bone mass (2 cases, 4.76%), mesenteric nodule (4 cases, 9.53%), kidney mass (3 cases, 7.14%), and 1 case (2.38%) each of epigastric mass and loin mass. Thirty-two (76.19%) cases were diagnosed as malignant and 10 (23.81%) cases were diagnosed as benign/negative on TIC. The overall sensitivity was 87.88%, the specificity was 77.78%, the positive predictive value was 93.55%, and the negative predictive value was 63.60%. The accuracy of the test was 85.71%.Conclusions: TIC is a simple and cost-effective method that aids in the diagnostic evaluation of tumors. It is fairly accurate with high positive predictive value and hence can be used as an adjunct to the biopsy diagnosis.
  603 74 -
CASE REPORTS
Pleomorphic adenoma of the soft palate: A case report with literature review
Sanjoy Panda, Manjunath Nml, Krupasindhu Panda
January-March 2018, 2(1):13-15
DOI:10.4103/oji.oji_4_18  
Pleomorphic adenoma is a benign mixed salivary gland tumor and consists of a combination of epithelial and mesenchymal elements. The parotid and other major salivary glands are the common locations for it. Pleomorphic adenoma less frequently originates from minor salivary glands with a malignant potential in most of the cases. The present case is a pleomorphic adenoma of the minor salivary gland of soft palate in a 72-year-old male, and the tumor is large, well circumscribed, firm but still benign in nature and needs reporting.
  599 66 -
Utility of spectral domain optical coherence tomography in a case of choroidal metastasis to monitor response to treatment
Prajakta Pramod Patil, Anand Subramanyam
January-March 2018, 2(1):19-21
DOI:10.4103/oji.oji_5_18  
Serial spectral domain optical coherence tomography (SD-OCT) images can be applied to monitor the effectiveness of systemic treatment in choroidal metastasis. Besides, it can be used as a guide to shifting to alternate therapy in nonresponding cases. SD-OCT was performed in a patient of primary adenocarcinoma of the lung with choroidal metastasis in the right eye. SD-OCT revealed neurosensory detachment overlying metastasis and involving macula. The patient was started on chemotherapy and external beam radiotherapy. After treatment completion, neurosensory detachment resolved completely with the regaining of normal foveal contour and improvement in visual acuity.
  613 50 -
Synchronous bilateral testicular metastasis in gastric carcinoma: A rare case report
Dipti Rani Samanta, Surendra Nath Senapati, Ajitesh Avinash, Sugyan Nandan Mohanty
January-March 2018, 2(1):10-12
DOI:10.4103/oji.oji_3_18  
Testicular metastasis from a solid malignancy of the distant organ is a rare entity and prostate, gastrointestinal tract, lungs, skin, and kidneys are the common primaries. Gastric carcinoma with testicular metastasis is an extremely rare entity with only few cases reported in the literature. Most of the testicular metastases are unilateral. Synchronous bilateral testicular metastasis is an extremely rare situation in gastric primary. We report a first case of synchronous bilateral testicular metastasis in a treated case of gastric carcinoma in India.
  573 76 -