G. Singh, Pragya Singh, Vikas K Yadav, P. B. Shanmuga, K. Periasamy
Cutaneous and renal metastasis in patients with squamous cell carcinoma of head and neck is a rare phenomenon. The reported incidence of skin metastasis in these cases is less than 1%, while the exact incidence of renal metastasis is still unknown. In the literature available only one case of renal metastasis from carcinoma tongue has been reported so far. We report a rare occurrence of isolated cutaneous and renal metastasis in an already treated case of carcinoma tongue.
{"title":"Unusual Sites of Metastases in Carcinoma Tongue – A Case Report","authors":"G. Singh, Pragya Singh, Vikas K Yadav, P. B. Shanmuga, K. Periasamy","doi":"10.5530/ogh.2017.6.2.22","DOIUrl":"https://doi.org/10.5530/ogh.2017.6.2.22","url":null,"abstract":"Cutaneous and renal metastasis in patients with squamous cell carcinoma of head and neck is a rare phenomenon. The reported incidence of skin metastasis in these cases is less than 1%, while the exact incidence of renal metastasis is still unknown. In the literature available only one case of renal metastasis from carcinoma tongue has been reported so far. We report a rare occurrence of isolated cutaneous and renal metastasis in an already treated case of carcinoma tongue.","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125937823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Follicular thyroid carcinomas (FTC) usually have a relatively benign clinical course, with good long-term prognosis. The most common sites of metastases are lung and bone. Fine needle aspiration cytology (FNAC) plays an important role in the diagnosis and early detection of metastatic FTC. It is important to identify the presence of distant metastasis as it is the most important prognostic indicator (associated with 50% mortality). Case history: We report three cases who presented with multiple swellings and bony involvement at different sites. In all the three cases, aspiration cytology revealed the diagnosis of metastatic follicular thyroid carcinoma. Conclusion: Cytologic diagnosis of metastatic FTC has been reported rarely. Epithelial cells arranged in repitative microfollicular pattern aids in making the diagnosis of metastatic FTC. It’s significant as this has a direct bearing upon the management of the patient. Hence more awareness is required for both pathologist and clinicians regarding the diagnosis of metastatic FTC.
{"title":"Cytodiagnosis Of Follicular Carcinoma Thyroid From Metastatic Sites: A report Of Three Cases","authors":"T. Santosh, M. Patro, A. Bal, N. Puneeta","doi":"10.5530/ogh.2017.6.2.18","DOIUrl":"https://doi.org/10.5530/ogh.2017.6.2.18","url":null,"abstract":"Background: Follicular thyroid carcinomas (FTC) usually have a relatively benign clinical course, with good long-term prognosis. The most common sites of metastases are lung and bone. Fine needle aspiration cytology (FNAC) plays an important role in the diagnosis and early detection of metastatic FTC. It is important to identify the presence of distant metastasis as it is the most important prognostic indicator (associated with 50% mortality). Case history: We report three cases who presented with multiple swellings and bony involvement at different sites. In all the three cases, aspiration cytology revealed the diagnosis of metastatic follicular thyroid carcinoma. Conclusion: Cytologic diagnosis of metastatic FTC has been reported rarely. Epithelial cells arranged in repitative microfollicular pattern aids in making the diagnosis of metastatic FTC. It’s significant as this has a direct bearing upon the management of the patient. Hence more awareness is required for both pathologist and clinicians regarding the diagnosis of metastatic FTC.","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123832613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatty infiltration of the liver commonly occurs in a diffuse pattern. However, in very rare presentation in the form of multiple focal lesions of the liver, mimicking metastases do occur. Accurate diagnosis is important to differentiate this condition from metastatic liver disease and hepatobiliary infections. We report a patient who consumed long term herbal remedies, presenting with multifical liver lesions that mimicked metastatic disease and in whom, specialized imaging and a needle biopsy proved the cause to be due to multifocal fatty infiltration of the liver.
{"title":"Drug Induced Atypical Multifocal Variant of Fatty Liver Disease Mimicking Metastatic Liver Disease","authors":"C. Philips, Vivek Kasana","doi":"10.5530/OGH.2017.6.2.17","DOIUrl":"https://doi.org/10.5530/OGH.2017.6.2.17","url":null,"abstract":"Fatty infiltration of the liver commonly occurs in a diffuse pattern. However, in very rare presentation in the form of multiple focal lesions of the liver, mimicking metastases do occur. Accurate diagnosis is important to differentiate this condition from metastatic liver disease and hepatobiliary infections. We report a patient who consumed long term herbal remedies, presenting with multifical liver lesions that mimicked metastatic disease and in whom, specialized imaging and a needle biopsy proved the cause to be due to multifocal fatty infiltration of the liver.","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125415720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Most colonic injuries are due to penetrating abdominal trauma. Colon injury rarely occurs after blunt abdominal trauma. Colonic trauma is usually associated with other intra-abdominal and extra-abdominal injuries. The low incidence of colon injury due to blunt abdominal trauma and the lack of a definitive diagnostic method for the same can lead to delays in diagnosis and treatment, subsequently resulting in high morbidity and mortality. Case presentation: a 25-years-old man who present after seven days of blunt abdominal trauma with clinical evidence of peritonitis, on laparotomy isolated sigmoid colon perforation was found which was managed with end colostomy. Conclusion: Isolated colon injury after blunt abdominal trauma is rare and difficult to diagnose. Delay in diagnosis increases the morbidity and mortality rates. Therefore it is important for the trauma surgeon to keep high index of suspicion colonic perforation, to facilitate its timely diagnosis and management.
{"title":"Delayed Presentation of an Isolated Sigmoid Colon Injury Following Blunt Abdominal Trauma: A Case Report & Review of Literature","authors":"S. Singh, Amandeep, Vundavalli Sattibabu","doi":"10.5530/OGH.2017.6.2.21","DOIUrl":"https://doi.org/10.5530/OGH.2017.6.2.21","url":null,"abstract":"Introduction: Most colonic injuries are due to penetrating abdominal trauma. Colon injury rarely occurs after blunt abdominal trauma. Colonic trauma is usually associated with other intra-abdominal and extra-abdominal injuries. The low incidence of colon injury due to blunt abdominal trauma and the lack of a definitive diagnostic method for the same can lead to delays in diagnosis and treatment, subsequently resulting in high morbidity and mortality. Case presentation: a 25-years-old man who present after seven days of blunt abdominal trauma with clinical evidence of peritonitis, on laparotomy isolated sigmoid colon perforation was found which was managed with end colostomy. Conclusion: Isolated colon injury after blunt abdominal trauma is rare and difficult to diagnose. Delay in diagnosis increases the morbidity and mortality rates. Therefore it is important for the trauma surgeon to keep high index of suspicion colonic perforation, to facilitate its timely diagnosis and management.","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117018556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Progressive familial intrahepatic cholestasis (PFIC) type 3 (PFIC3) is an autosomal recessive disorder of biliary phospholipid excretion leading to cholestasis and biliary cirrhosis. These cholestatic disorders show falsely elevated urinary copper and low ceruloplasmin together with increase in copper associated protein content on liver tissue mimicking Wilson’s disease leading to diagnostic delay. Case Report: We report a case of a 21-yearold male who presented with complaints of gradually progressive jaundice with ascites for past 3 months. His work up revealed low serum ceruloplasmin and high 24-hour urinary copper. He was diagnosed as having Wilson’s disease and living donor liver transplant was performed. Explant liver revealed prominent copper associated protein within hepatocytes and numerous Mallory Denk Bodies, findings suggestive of Wilson’s etiology for cirrhosis. Patient was discharged in a stable condition. The story continued when 4 months later his 3 siblings (20 year male, 15 year old female and 11 year old female) came with complaints of itching all over the body were evaluated. Possibility of PFIC3 was kept in differential this time due to clinical scenario and liver biopsies were performed in all three. Liver biopsy in all shows prominent bile ductular reaction, increased fibrosis and hepatic copper associated protein. MDR3 immunostains was performed in these cases was negative. Index patient slides were retrieved and MDR3 stain performed showed absent staining confirming the diagnosis of PFIC 3. Conclusion: Cholestatic liver diseases frequently mimic Wilson’s disease. Criteria for diagnosis of Wilson’s does not completely holds true for cholestatic liver diseases in children and adolescents.
{"title":"An Itchy Experience - PFIC 3 Masquerading as Wilson’s Disease; Learning from Mistakes","authors":"N. Bansal, M. Rastogi","doi":"10.5530/OGH.2017.6.2.19","DOIUrl":"https://doi.org/10.5530/OGH.2017.6.2.19","url":null,"abstract":"Introduction: Progressive familial intrahepatic cholestasis (PFIC) type 3 (PFIC3) is an autosomal recessive disorder of biliary phospholipid excretion leading to cholestasis and biliary cirrhosis. These cholestatic disorders show falsely elevated urinary copper and low ceruloplasmin together with increase in copper associated protein content on liver tissue mimicking Wilson’s disease leading to diagnostic delay. Case Report: We report a case of a 21-yearold male who presented with complaints of gradually progressive jaundice with ascites for past 3 months. His work up revealed low serum ceruloplasmin and high 24-hour urinary copper. He was diagnosed as having Wilson’s disease and living donor liver transplant was performed. Explant liver revealed prominent copper associated protein within hepatocytes and numerous Mallory Denk Bodies, findings suggestive of Wilson’s etiology for cirrhosis. Patient was discharged in a stable condition. The story continued when 4 months later his 3 siblings (20 year male, 15 year old female and 11 year old female) came with complaints of itching all over the body were evaluated. Possibility of PFIC3 was kept in differential this time due to clinical scenario and liver biopsies were performed in all three. Liver biopsy in all shows prominent bile ductular reaction, increased fibrosis and hepatic copper associated protein. MDR3 immunostains was performed in these cases was negative. Index patient slides were retrieved and MDR3 stain performed showed absent staining confirming the diagnosis of PFIC 3. Conclusion: Cholestatic liver diseases frequently mimic Wilson’s disease. Criteria for diagnosis of Wilson’s does not completely holds true for cholestatic liver diseases in children and adolescents.","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117022592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Philips, Praveen Kumar, P. Augustine, P. Mahadevan
{"title":"Uncommon cause for a common disease-Severe steatohepatitis secondary to Ayurvedic ‘Man-Lion Tonic’","authors":"C. Philips, Praveen Kumar, P. Augustine, P. Mahadevan","doi":"10.5530/ogh.2017.6.2.15","DOIUrl":"https://doi.org/10.5530/ogh.2017.6.2.15","url":null,"abstract":"","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132911174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suresh Babu Mallekavu Chikkadasappa, G. Kanakasetty, Lokesh Kadabur Nagendrappa, S. Rao
Pemetrexed, a drug used in lung cancer and pleural mesotheliomas is mainly associated with hematological toxicities. Cutaneous toxicities, although well known are rare. This is a case of a metastatic adenocarcinoma lung with recurrent and localised skin lesions following each cycle of pemetrexed, which is the first report of its kind.
{"title":"Unusual Cutaneous reactions to Pemetrexed in a Patient with Metastatic non-small cell Lung Cancer","authors":"Suresh Babu Mallekavu Chikkadasappa, G. Kanakasetty, Lokesh Kadabur Nagendrappa, S. Rao","doi":"10.5530/ogh.2017.6.1.11","DOIUrl":"https://doi.org/10.5530/ogh.2017.6.1.11","url":null,"abstract":"Pemetrexed, a drug used in lung cancer and pleural mesotheliomas is mainly associated with hematological toxicities. Cutaneous toxicities, although well known are rare. This is a case of a metastatic adenocarcinoma lung with recurrent and localised skin lesions following each cycle of pemetrexed, which is the first report of its kind.","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121078167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pseudomembranous colitis is caused almost exclusively by toxins produced by Clostridium difficile (CD). There may be mild nonspecific diarrhea to severe colitis with toxic megacolon, perforation, and death.[1] It is a well-known fact that Clostridium difficile infection (CDI) is a significant problem for patients as well as physicians. CDI recurrence is a more complicated issue. Limited treatment options and infection control issues make the condition worse. Though fecal microbiota transplantation (FMT) is a promising therapy, it is not readily available. Randomized, double-blind, noninferiority trial has been done to determine whether frozen-and-thawed FMT is noninferior to fresh FMT regarding clinical efficacy. Fecal microbiota transplantation has been demonstrated to be linked to the resolution of symptoms of recurrent CDI. Its efficacy in primary and severe CDI is yet to be established.[2] Recently, 232 adults were enrolled in this trial (NCT01398969) with recurrent or refractory CDI. It was conducted between July 2012 and September 2014. Patients were randomly given frozen (n=114) or fresh (n=118) FMT via enema. Resolution of diarrhea clinically without relapse at 13 weeks and adverse events were the primary outcomes. The number of patients with clinical improvement for the frozen FMT group and the fresh FMT group showed no significant difference. (P-value for noninferiority =0.01). The use of frozen in comparison to fresh FMT did not show the worse proportion of clinical resolution of diarrhea in recurrent or refractory CDI. Frozen FMT can be a reasonable option in this setting.[3] Recurrent CDI is a problematic issue for long especially for old patients, patients in critical care and patients with other comorbidities. One-fourth of patients may have recurrent infection. CDI is often refractory to given antimicrobial agents. Naturally, FMT in Clostridium difficile: frozen or fresh?
{"title":"FMT in Clostridium Difficile: Frozen or Fresh?","authors":"A. Hajra, D. Bandyopadhyay","doi":"10.5530/OGH.2017.6.1.13","DOIUrl":"https://doi.org/10.5530/OGH.2017.6.1.13","url":null,"abstract":"Pseudomembranous colitis is caused almost exclusively by toxins produced by Clostridium difficile (CD). There may be mild nonspecific diarrhea to severe colitis with toxic megacolon, perforation, and death.[1] It is a well-known fact that Clostridium difficile infection (CDI) is a significant problem for patients as well as physicians. CDI recurrence is a more complicated issue. Limited treatment options and infection control issues make the condition worse. Though fecal microbiota transplantation (FMT) is a promising therapy, it is not readily available. Randomized, double-blind, noninferiority trial has been done to determine whether frozen-and-thawed FMT is noninferior to fresh FMT regarding clinical efficacy. Fecal microbiota transplantation has been demonstrated to be linked to the resolution of symptoms of recurrent CDI. Its efficacy in primary and severe CDI is yet to be established.[2] Recently, 232 adults were enrolled in this trial (NCT01398969) with recurrent or refractory CDI. It was conducted between July 2012 and September 2014. Patients were randomly given frozen (n=114) or fresh (n=118) FMT via enema. Resolution of diarrhea clinically without relapse at 13 weeks and adverse events were the primary outcomes. The number of patients with clinical improvement for the frozen FMT group and the fresh FMT group showed no significant difference. (P-value for noninferiority =0.01). The use of frozen in comparison to fresh FMT did not show the worse proportion of clinical resolution of diarrhea in recurrent or refractory CDI. Frozen FMT can be a reasonable option in this setting.[3] Recurrent CDI is a problematic issue for long especially for old patients, patients in critical care and patients with other comorbidities. One-fourth of patients may have recurrent infection. CDI is often refractory to given antimicrobial agents. Naturally, FMT in Clostridium difficile: frozen or fresh?","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122364006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gallbladder Cancer Research: A Scientometric Study of Indian Publications during 2006-15","authors":"Ritu Gupta, K. Ahmed, B. Gupta, A. K. Garg","doi":"10.5530/OGH.2017.6.1.1","DOIUrl":"https://doi.org/10.5530/OGH.2017.6.1.1","url":null,"abstract":"","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122824933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cutaneous metastasis is a rare manifestation of visceral malignancies, a phenomenon seen in 1% to 3% of all metastasizing tumors. A 62 years old female presented with multiple skin nodules in the neck and jaundice for 2 months. FNAC from the skin nodules revealed hypercellular smear composed of malignant epithelial cells arranged in clusters and glandular patterns. A provisional diagnosis of metastatic adenocarcinoma was given. USG and CT-scan of abdomen revealed a tumor in gallbladder fossa. USG guided FNAC and later on histopathological examination from the biopsy of the gallbladder tumor clinched the diagnosis of moderately differentiated gallbladder adenocarcinoma. Biopsy from the skin nodules revealed adenocarcinoma metastasis in skin. The patient was given postoperative chemotherapy and radiotherapy. Follow up period (3 months) was eventful.
{"title":"FNAC Diagnosis of Gallbladder Adenocarcinoma presenting as multiple skin Nodules and Jaundice","authors":"S. Mondal, Debashish Bhattacharjee","doi":"10.5530/ogh.2017.6.1.5","DOIUrl":"https://doi.org/10.5530/ogh.2017.6.1.5","url":null,"abstract":"Cutaneous metastasis is a rare manifestation of visceral malignancies, a phenomenon seen in 1% to 3% of all metastasizing tumors. A 62 years old female presented with multiple skin nodules in the neck and jaundice for 2 months. FNAC from the skin nodules revealed hypercellular smear composed of malignant epithelial cells arranged in clusters and glandular patterns. A provisional diagnosis of metastatic adenocarcinoma was given. USG and CT-scan of abdomen revealed a tumor in gallbladder fossa. USG guided FNAC and later on histopathological examination from the biopsy of the gallbladder tumor clinched the diagnosis of moderately differentiated gallbladder adenocarcinoma. Biopsy from the skin nodules revealed adenocarcinoma metastasis in skin. The patient was given postoperative chemotherapy and radiotherapy. Follow up period (3 months) was eventful.","PeriodicalId":166206,"journal":{"name":"Oncology, Gastroenterology and Hepatology Reports","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114260897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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