Multidisciplinary Approach for an Initially Misdiagnosed Case of Osteosarcoma in a Medically Compromised Patient.

Osteosarcoma is a highly malignant bone tumour. It is derived from primitive mesenchymal bone forming cell. Osteosarcoma of the jaw is quite rare. Despite its rarity, the dentist may be the first health professional who observes tumours involving the jaws. As there is a greater variability in clinical, radiological and histopathological findings of jaw osteosarcoma, so there is greater scope for multidisciplinary approach. An early definite diagnosis is must for successful treatment which can save patient’s life and esthetic. This article presents a case of osteosarcoma in medically compromised 17 years old female patient who was misdiagnosed initially and later on present as a huge size of the tumour mass with gross disfigurement than she was treated by multidisciplinary approach of oncosurgeon, medical oncologist and radiation oncologist with appropriate expertise.

Intensity modulated radiotherapy in abdominal malignancies: our experience in reducing the dose to normal structures as compared to the gross tumor.

BACKGROUND AND PURPOSE: A better understanding of appropriate sequencing and use of multimodality approach in the management and subsequent improvement in overall survival mandates a vigil on quality of life issues. Intensity modulated radiotherapy (IMRT) is a powerful tool, which might go a long way in reducing radiation doses to critical structures and thereby reduce long term morbidities. The purpose of this paper is to evaluate the impact of IMRT in reducing the dose to the critical normal tissues while maintaining the desired dose to the volume of interest for abdominal malignancies. MATERIALS AND METHODS: During the period January 2002 to March 2004, 11 patients of various sites of malignancies in the abdominal region were treated using physical intensity modulator based IMRT. Plans of these patients treated with IMRT were analyzed using dose volume histograms. RESULTS: An average dose reduction of the mean values by 50% to the liver, 57% to the right kidney, 56% to the left kidney, 66% to the cord and 27% to the bowel, with respect to the GTV could be achieved with IMRT. The two-year disease free survival was 79% and two-year overall survival was 88%. The average number of IMRT fields used was six. CONCLUSION: IMRT with inverse planning enabled us to achieve desired dose distribution, due to its ability to provide sharp dose gradients at the junction of tumor and the adjacent critical organs.