ABSTRACT
We present a case of 53-year-old female who came with the complaints of mass on the right side of the abdomen noticed 3 weeks back. There was no history of localized swelling or rise of temperature, no history of weight loss, or evening rise of temperature. On examination, there was a flank mass which was bimanually palpable and tender. Routine laboratory investigations were within normal limits, except for the presence of hematuria in routine urinalysis. Computed tomography scan abdomen revealed a large multiloculated solid-cystic mass lesion with septation in the right-sided kidney. Cystic renal cell carcinoma was suspected and conventional open right radical nephrectomy was done. Grossly, the tumor was solid-cystic containing blood-tinged fluid. Microscopy revealed a complex tumor with both epithelial and stromal proliferation and with the aid of immunohistochemistry a diagnosis of mixed epithelial and stromal tumor undergoing malignant transformation was concluded.
ABSTRACT
Introduction: Warfarin/Acitrom administration dosage varies based on patient genotype with respect to the gene: Vitamin K epoxide reductase complex 1 (VKORC1). Ethnic diversity contributes to genotype variation. The frequency of polymorphism at VKORC1 in population of Hyderabad has not been reported in literature; hence the present study was conducted. Material & Methods: Genomic DNA from peripheral blood leukocytes of patients on warfarin/acitrom as well as normal control population without any thrombotic disease was extracted and Restriction Fragment Length Polymorphism (RFLP) pattern was established for 1173C>T transition by standard protocols. Result: The incidence of homozygote dominants (CC) genotypes were 74.63% and that of heterozygotes (CT) were 25.37 %. No recessives were found in the study group. Conclusion: Presently genotype based dosage is not implemented. This study through its collaboration with practising cardiologist while establishing the test at our diagnostic centre has also enabled awareness and consequently if followed will improve patient safety.