Malignant mesenchymal tumor of male breast: primary chondrosarcoma

Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of the breast. Pure and primary chondrosarcoma of the male breast would be an extremely rare tumor. It might arise either from the breast stroma itself, or from underlying bone or cartilage. A 65-year-old man has presented with a rapidly growing breast mass since 5 months. Physical examination has established a large firm to hard mass with regular margins in the region of right breast. There was no axillary lymphadenopathy. Contrast enhanced MRI of breasts has shown a mixed-signal intensity multi lobulated cystic-solid mass [10.4 cm × 10.3 cm ×9.9 cm] appearing predominantly hyper intense on T2W and hypo intense on T1W. The tumor has diagnosed as a low-grade chondrosarcoma of the breast by histopathological and immunohistochemistry analysis. Right sided radical mastectomy with grafting has done. It has seemed to be very important to identify the mammary primary sarcomas as entity separated from the carcinomas of the breast

Antioxidant, lipid peroxidation inhibition and free radical scavenging efficacy of a diterpenoid compound sugiol isolated from Metasequoia glyptostroboides

OBJECTIVE@#To investigate the antioxidant efficacy of a biologically active diterpenoid compound sugiol isolated from Metasequoia glyptostroboides (M. glyptostroboides) in various antioxidant models.@*METHODS@#An abietane type diterpenoid sugiol, isolated from ethyl acetate extract of M. glyptostroboides cones, was analyzed for its antioxidant efficacy as reducing power ability and lipid peroxidation inhibition as well as its ability to scavenge free radicals such as 1,1-diphenyl-2-picryl hydrazyl, nitric oxide, superoxide and hydroxyl radicals.@*RESULTS@#The sugiol showed significant and concentration-dependent antioxidant and free radical scavenging activities. Consequently, the sugiol exerted lipid peroxidation inhibitory effect by 76.5% as compared to α-tocopherol (80.13%) and butylated hydroxyanisole (76.59%). In addition, the sugiol had significant scavenging activities of 1,1-diphenyl-2-picryl hydrazyl, nitric oxide, superoxide and hydroxyl free radicals in a concentration-dependent manner by 78.83%, 72.42%, 72.99% and 85.04%, when compared to the standard compound ascorbic acid (81.69%, 74.62%, 73.00% and 73.79%) and α-tocopherol/butylated hydroxyanisole (84.09%, 78.61%, 74.45% and 70.02%), respectively.@*CONCLUSIONS@#These findings justify the biological and traditional uses of M. glyptostroboides or its secondary metabolites as confirmed by its promising antioxidant efficacy.

Diagnosis of post-radiotherapy local failures in nasopharyngeal carcinoma: a prospective institutional study

This prospective study was conducted to evaluate and compare the efficacies of nasopharyngoscopy and CT scan in the diagnosis of local failure of external beam radiotherapy [EBRT] for nasopharyngeal carcinoma. Total 52 patients of histopathologically proven nasopharyngeal carcinoma treated with external beam radiotherapy [EBRT], were included in this study. For every patient computed tomography [CT], nasopharyngoscopy and nasopharyngeal biopsies were performed 3 months after completion of EBRT. Three months after completion of EBRT, 9 patients [17.3%] had evident disease on histological examination of biopsies. Nasopharyngoscopy showed 77.78% sensitivity, 93.03% specificity, 70% positive predictive value and 95.24% negative predictive value in diagnosing the residual/recurrence of tumor. There was statistically significant agreement between the endoscopic findings and the histological findings [Kappa reliability coefficient=0.562, p<0.01]. On the other hand, CT scan showed a 55.56% sensitivity, 39.53% specificity, 16.13% positive predictive value and 80.95% negative predictive value in diagnosing the residual tumor/recurrence. There was no statistically significant agreement between the CT scan findings and the histological findings [Kappa reliability coefficient = 0.038, p>0.05]. Nasopharyngoscopy should be considered the primary follow-up tool after radiotherapy of nasopharyngeal carcinoma. CT scan should be reserved for patients with histological or any symptomatic indications. Routine postnasal biopsies are not required

Stentless laparoscopic pyeloplasty: a single center experience

To assess the effectiveness of laparoscopic stentless pyeloplasty for congenital ureteropelvic junction obstruction. This was a prospective comparative study conducted over a period of 5 years. The study included 35 cases of primary ureteropelvic junction obstruction [UPJO] with mean age of 2[.5 years, divided in two groups- Group A [stent-less, 18 patients] and Group B [stented, 17 patients]. Follow up ranged from one to 4years [mean 2 years]. Transperitoneal laparoscopic Anderson- Hyene's pyeloplasty was standard for both the groups. Perioperative and postoperative complications were prospectively collected and analyzed by Statistical Package for Social Sciences [SPSS] 17 version using Pearson chi square test. Both the groups were comparable with respect to preoperative differential renal function [DRF] and time required for maximum activity in minutes [t[max].min]. Average post operative DRF was significantly higher than preoperative DRF in both the groups. Average t[max] was significantly lower after pyeloplasty than pre operative t[max]. Mean operative time, mean duration of urethral catheter, and mean duration of drain removal were comparable in both the groups. However bothersome irritative lower urinary tract symptoms [LUTS] and hematuria were significantly more in group B patients [P < 0.0001 and <0.013 respectively]. In experienced hands, laparoscopic stentless pyeloplasty is as effective method for treating UPJO as its stented counterpart. It is cost effective, avoids stent-related morbidity, and could be performed without compromising the success rate. However, more randomized studies are needed to evaluate the safety of stentless pyeloplasty

Double primary malignancies: a clinical and pathological analysis report from a regional cancer institute in India

Patients which have diagnosed with a cancer, have a life time risk for developing another de novo malignancy depending on various inherited, environmental and iatrogenic risk factors. Cancer victims could survive longer due to settling treatment modalities, and then would likely develop a new metachronous malignancy. This article aims to report our observed trend of increasing, in prevalence of both synchronous and metachronous second primary malignancy, among the cancer victims, and to review the relevant literature. A hospital based retrospective gathering of prospective data, among the patients that have diagnosed with second de novo malignancy. The study has conducted over a 4 years period from 2009 to 2012. All patients that have diagnosed with a histologically proven second malignancy as per Warren and Gates criteria have included. Various details which have regarded site, age at presentation, sex, synchronous or metachronous, treatment have recorded. Among 41 cases of multiple primary malignancies that have observed, 8 were synchronous [19.51%] and 33 were metachronous [80.49%]. Out of 41 patients, 25 [60.98%] were females and 16 [39.02%] were males. The most common sites of primary tumor were head and neck cancers that have followed by gynecological cancers, breast cancer, lung cancer, esophageal cancer, and then the others. Among the second malignancy, the most common site was breast and gastrointestinal tract that have followed by lung and gynecological cancers. Out of the total number of cases with double location, 14 tumors [34.15%] have belonged to the breast, out of which 5 [12.20%] have represented first locations and 7 [17.07%] have been second locations. Both locations have belonged to the breast in 2 patients [4.9%]. In 5 cases [12.20%], there were associations of breast-cervix and in 6 cases [14.63%], there were association of lung-head and neck cancers. The incidence of multiple primary malignancies has not been rare at all. Screening procedures have especially been useful for the early detection of associated tumors, whereas careful monitoring of patients has treated for primary cancer, and then a good communication between patients and medical care team would certify not only an early detection for secondary tumors, but only finally and subsequently, an appropriate management