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Metastatic involvement of the optic nerve or its sheath is very rare [1.3 - 3%]. The most common malignancies reported to metastasize to the optic nerve or its sheath are breast, lung, kidney, bladder, gastric and colorectal cancers. Carcinoma of uterine cervix metastatic to optic nerve and optic nerve sheath is extremely rare and is associated with grave prognosis due to underlying high tumor burden. Here in, we report a 61-year Saudi woman who was treated with concurrent chemoradiation for squamous cell carcinoma of cervix FIGO IVA 6 months back. She presented with pain and progressive visual loss in the right eye. Magnetic resonance imaging showed enhanced solid mass of the intraorbital optic nerve consistent with optic nerve sheath meningioma. Immunostaining [CK5/6, CAM 5.2, p63 and p16] confirmed the diagnosis of metastatic squamous cell carcinoma of uterine cervix
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Objectives: To determine the knowledge, attitudes and practices [KAP] of urban women in Riyadh regarding Breast Cancer [BC] and its available screening and treatment modalities. Design: Cross-sectional descriptive study. Setting: BC Awareness day campaigns conducted in Riyadh city from October 2010 to October 2013
Subjects: Six hundred females aged more than 18 years who responded to a well-structured questionnaire comprising of 37 questions. Main Outcome Measures: The level of knowledge and awareness regarding the risk factors and prevention of BC, misconceptions, symptomatology including KAP, regarding self breast examination [SBE], mammography and treatment for BC
Results: Out of the 600 participants with a mean age of 31.9 years [ +/- 10.49], 342 [57.0%] were married, and 215 [35.8%] were employed. The education level was considerably high; with 363 [60.5%] graduates. Late child bearing age [48.2%], positive family history [75%], increase in age [83.5%], and fatty diet [60.5%] were reported important risk factor for BC. A breast lump [70.8%], underarm lump [60.2%], breast pain [53.7%], change in nipple shape [58.7%] and nipple discharge [51.8%] were reported as the important symptoms for BC. About 348 [58.0%] had heard about SBE and 290 [48.3%] knew how to perform SBE. Nearly 433 [72.2%] believed that early detection for BC is possible with mammography and sound waves. Only 42 [7.0%] knew the treatment for BC. Majority of women 565 [94.2%] wanted more media awareness campaigns regarding the issue
Conclusion: There is an immediate need for an aggressive campaign to increase awareness regarding BC in Saudi Arabia
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Objectives: Aim was to evaluate clinicopathological and treatment outcomes of diffuse sclerosing variant papillary thyroid carcinoma [DSV-PTC]. Design: Retrospective study. Setting: Two major tertiary care hospitals of Riyadh, Saudi Arabia
Material: Medical records of 1192 patients with confirmed papillary thyroid cancers [PTC], who were treated or followed up during the period of July 2000 and December 2012 were reviewed. Main outcome measure: To evaluate the clinicopathologic features and treatment outcomes of patients with DSV- PTC and perform comparative analysis of DSV-PTC with classic-variant PTC [CV-PTC]
Results: A total of 44 cases [3.7%] of DSV-PTC were identified. DSV-PTC patients were younger than their CV-PTC [p = 0.001]. The mean tumor size was larger in DSV-PTC as compared to CV-PTC [p < 0.0001]. Advanced pathologic tumor [pT] stage and positive lymph nodes were more often present in DSV-PTC than in CV-PTC [p < 0.0001 and p < 0.0001 respectively]. Median follow-up was 8.05 years [range: 1.62-11.4]. Ten-year disease-specific survival [DSS] rates were lower in DSV-PTC [74.4%] than in CV-PTC [89.4%]; p = 0.001
Conclusion: DSV-PTC is more aggressive variant as compared to CV-PTC, and is associated with inferior DSS rates. An aggressive surgical approach followed by radioiodine therapy is warranted for these patients
ABSTRACT
Metastasis to the head and neck region from primary is rarest manifestation. Lung and breast carcinomas are the commonest malignancies to metastasize to the head and neck region. Oesophageal adenocarcinoma with metastasis to the oral cavity is a rarest presentation and is associated with dismal prognosis. Only few related case reports have been published so far. Her-in we report a case of 55 years old male who underwent radical oesophagectomy for adenocarcinoma of lower oesophagus twelve months back, now presented with hard mass in the right margin of tongue which was suspected as primary tongue carcinoma; subsequently was confirmed as metastatic oesophageal adenocarcinoma following excision. Two months after tongue excision, patient died of progressive metastatic disease
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A Thyroglossal duct cyst [TGDC] is the most frequent congenital cervical anomaly [70% in children and 7% in adults] in the development of the thyroid gland. However, incidence of carcinoma arising from a TGDC is extremely rare [
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Skin and subcutaneous metastases are uncommon, and mostly originating from cancers of the breast, kidney, colon, lung, and melanoma. Oesophageal cancers rarely metastasise to the skin and subcutaneous soft tissue. Skin and subcutaneous metastases are associated with dismal prognosis. Only few related case reports have been published so far. In this report, we describe a 52 year old patient with lower oesophageal adenocarcinoma who developed subcutaneous metastasis, 9 months after neoadjuvant che-moradiation followed by trans-hiatal esophagectomy
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Metastatic paranasal sinuses and orbital cancer is very rare. The patient with sinusitis and orbital symptoms warrants a detailed history, complete physical examination and serial radiological tests [sinus radiographs and CT scan] to rule out any metastatic disease and prompt treatment. We present a case of 65 years old patient with metastatic prostate cancer who presented to us with left ethmoid sinuses and orbital metastasis causing ipsilateral proptosis
Subject(s)
Humans , Male , Orbital Neoplasms/pathology , Ethmoid Sinus , Neoplasm Metastasis , Exophthalmos , Prostatic Neoplasms/secondary , Paranasal Sinus Neoplasms/diagnostic imaging , BiopsyABSTRACT
Metastatic prostate adenocarcinoma generally manifests either as painful bone metastases often in axial skeleton or as bulky iliac and para-aortic lymphadenopathy. The inguinal lymphadenopathy is very rare. Here-in we present an unusual case of metastatic prostate adenocarcinoma with bilateral inguinal adenopathy
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Hereditary nonpolyposis colorectal cancer [HNPCC] is the most common form of hereditary bowel cancer. Multiple generations are affected with colorectal cancer at relatively young age, between 25 and 45 years. We conducted this study to investigate the frequency of HNPCC in Pakistani population, due to the high incidence of colorectal cancer in younger Pakistani adults and prevalence of consanguinity in this region. Ninety histopathologically confirmed colorectal cancer patients between 12-50 years and their families were interviewed using a detailed questionnaire. The questions about family history of colorectal cancer, history of other cancers, age at diagnosis and consanguinity were asked. The pedigrees were drawn for all families based on given information. To confirm cancers reported in relatives, hospital records were also reviewed. Amsterdam criteria were used to label a family as HNPCC. Seventeen patients [18.9%] had one or more first or second degree relatives under age 50 years with colorectal cancers suggestive of HNPCC. Another 15 patients [16.7%] had first or second degree relatives with a family history of other extra-colonic cancers including ovarian, breast, endometrium, lung, parotid, brain and bladder cancer. Of these 30 patients [33.3%] reported that their parents were first degree cousins. High frequency of HNPCC was seen in Pakistani population; higher proportion of colorectal cancer in young Pakistanis, strong prevalence of consanguineous marriages could be important factors for HNPCC occurrence in Pakistan. However future studies with large sample size along with genetic testing and screening programmes are warranted
Subject(s)
Humans , Male , Female , Consanguinity , Surveys and Questionnaires , PrevalenceABSTRACT
Hereditary nonpolyposis colorectal cancer [HNPCC] is the most common form of hereditary bowel cancer. Multiple generations are affected with colorectal cancer at relatively young age, between 25 and 45 years. To investigate the frequency of HNPCC in Pakistani population, due to the high incidence of colorectal cancer in younger Pakistani adults and prevalence of consanguinity in this region conducted this study. November 2008 and January 2010. Ninty histopathologically confirmed colorectal cancer patients between 12- 50 years and their families were interviewed using a detailed questionaire. The questions about family history of colorectal cancer, history of other cancers, age at diagnosis and consanguinity were asked. The pedigrees were drawn for all families based on given information. Hospital records were also reviewed to confirm cancers reported in relatives. Amsterdam criteria was used to label a family as HNPCC. Seventeen patients [18.9%] had one or more first or second degree relatives under age 50 years with colorectal cancers suggestive of HNPCC. Another 15 patients [16.7%] had first or second degree relatives with a family history of other extra-colonic cancers including ovarian, breast, endometrium, lung, parotid, brain and bladder cancer. Of these 30 patients [33.3%] reported that their parents were first degree cousins. 1. High frequency of HNPCC is seen in Pakistani population. 2. Higher proportion of colorectal cancer is seen in young Pakistanis. Strong prevalence of consanguineous marriages could be important factors for HNPCC occurrence in Pakistan. Future studies with large sample size along with genetic testing and screening programmes are warranted
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Most metastases of cancers to cervical lymph nodes including supra-clavicular chain are from the head and neck primary tumors. Cancers metastasizing to the supra-calvicular lymph nodes from non-head and neck origin are rare. This occurs most frequently with lung, breast and esophagus. For prostate cancer, the non-regional lymph nodal involvment is very rarely reported. Similarly renal cell carcinoma presents mostly in advanced stage disease with involvment of non-regional lymph nodes is much less common. We present two cases of prostate and renal cell carcinoma who presented with initial manifestation of supraclavicular lymphadenopathy
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We evaluated the treatment outcome and associated prognostic factors for patients with nonseminomatous testicular germ cell tumours [NSGCT], who were treated in our hospital during last 15 years. Data was retrospectively analyzed for the 1995 through 2010 period. One hundred and twenty patients with NSGCT were identified. Descriptive Data was analyzed for the age, risk factors, site, histology, stage, chemotherapy regimen, retroperitoneal lymph node dissection [RPLND] and radiological response. The disease free survival [DFS] and overall survival [OS] were determined by Kaplan and Meier method and statistical inferences with the log-rank test. Cox proportional hazards Model was used to find different prognostic factors. Mean age of patients was 29.65 years [16-45]. Pain and swelling of testis was commonest presentation [30%]. Right sided were predominant [63.3%]. Predominant stage was IIIC [55%] and commonest histology was mixed [embryonal cell carcinoma+yolk sac tumor+teratoma] in 45% cases. Majority of patients were poor risk according to International Germ Cell Cancer Consensus Classification [IGCCC], 41.7%. Bleomycin, etoposide and cisplatinum [BEP] chemotherapy was mostly as a first line treatment [87.5%]. Postchemotherapy RPLND was performed in 31 patients [25.8%]. Histology among residuals was fibrosis [48.4%], viable tumors [35.5%] and mature teratoma [16.1%]. Median DFS and OS were 9 and 9.1 years respectively. Stage, IGCCC, RPLND were found important prognostic factors [p < 0.001]. Better outcome with lower disease burden and lower IGCCC and multidiscplinary approach warrants public awareness should be carried out for the testicular self-examination to reduce the time from the beginning of symptoms to time of seeking treatment