Clinicopathological study of malignant melanoma in a regional cancer center

BACKGROUND: Malignant melanoma is a tumor of melanocytic origin. Although uncommon in India as compared with the west, its prevalence is increasing. OBJECTIVES: To document the pattern of clinicopathological features of malignant melanoma cases attending in a regional cancer center in eastern India. MATERIAL AND METHODS: The present study was a retrospective study of 182 cases diagnosed histopathologically as malignant melanoma during 2011–2016. RESULTS: Out of the total cases, 170 (93.4%) were cutaneous and 12 (6.6%) were noncutaneous melanoma. The most common age group was sixth decade with a male predominance. Conventional melanotic melanomas were 176 (96.70%), and only 6 cases (3.30%) were amelanotic melanoma. Among noncutaneous melanomas, 6 were in anorectum, 2 in conjunctiva, and 1 case each in nasal cavity, palate, gingivo-buccal sulcus, and vagina. The acrallentigenous type was the most common variety, and the mixed epithelioid and spindle cell type was the most common histopathological pattern. Clark's level III was the most common level of invasion. CONCLUSION: The lower extremity is the most common site for melanoma, whereas extracutaneous melanomas are exceedingly rare and aggressive neoplasms. Melanoma can metastasize to regional lymph nodes, however, visceral metastasis to liver can also occur. In the absence of pigment in amelanotic melanoma, immunohistochemical markers such as HMB 45 can be used for definitive diagnosis.

Cervical strongyloidiasis in an immunocompetent patient: A clinical surprise.

A 32-year-old lady came for a routine gynecological check up. Her cervical cytologic smear was reported as low grade squamous intraepithelial lesion. As a part of basic routine investigation, cervical punch biopsy was done. Astonishingly it revealed multiple rhabditiform larvae of Strongyloides stercoralis. These were curved thick with pointed end and a short buccal cavity. She did not have any history of immunosuppression including steroid therapy and was otherwise normal. Extensive review of the literature on parasites encountered in cervix yielded few case reports on strongyloides in cytologic smears, but failed to reveal any report till date on S. stercoralis found in histopathology section. Our case is probably the fi rst in the world and the fi rst reported from India to the best of our knowledge. We describe this case of strongyloidiasis of cervix with review of the literature on various parasites encountered in the cervix because of its rarity and also to keep this parasitic infestation as a differential diagnosis of cervical lesions.

Prevalence of nonalcoholic fatty liver disease in coastal eastern India: a preliminary ultrasonographic survey.

Non-alcoholic fatty liver disease (NAFLD) is a common clinical condition which is fast assuming importance as a possible precursor of more serious liver disorders, including cirrhosis of the liver and hepatocellular carcinoma. There are no data in the published English literature on the prevalence of NAFLD in India. The present study was performed to assess a prevalence of NAFLD by ultrasonography in a general population in coastal eastern India. Asymptomatic, apparently healthy attendants accompanying the patients attending the Gastroenterology outpatient were subjected to abdominal ultrasonographic examination for the presence of fatty liver; individuals who gave a history of alcohol abuse were excluded from the study. The subjects of the study comprised 159 apparently healthy attendants, who underwent ultrasonography. Fatty liver was diagnosed by ultrasonography in 39 of these 159 persons (24.5%). Fatty liver was seen more commonly in males (26.9%) than in females (13.8%). Persons with ultrasonographic fatty liver had a higher body mass index (BMI) (mean 25.9 +/- 4.17 kg/m2) than persons without fatty liver (mean 22.1 +/- 3.27 kg/m2) (p<0.001). The estimated prevalence of NAFLD in an unselected apparently healthy and asymptomatic population as detected by ultrasonography in our study was found to be 24.5%. This is similar to the prevalence rate published from the west. However, contrary to figures from the west, males appeared to have a greater predilection for fatty liver than females in our study. NAFLD is perhaps as common in developing world as in the developed countries despite a lower prevalence of obesity. Indian males may have a greater genetic predisposition to developing NAFLD.

Hepatoblastoma--report of three cases.

Hepatoblastoma accounts for only 0.5% of all paediatric tumours. The vast majority of these cases are seen under five years of age and a third of patients have some form of congenital anomaly syndrome or other childhood tumour. Most recent classification describes six subtypes of hepatoblastoma. Surgical resection is the best treatment preceded by accurate staging and chemotherapy or radiotherapy. Hepatoblastoma can be diagnosed by Fine Needle Aspiration Cytology (FNAC). We report here three cases of hepatoblastoma diagnosed by FNAC and subsequently confirmed by histopathology following resection of hepatic tumours.

Squamous cell carcinoma of breast--report of two case.

Squamous cell carcinoma is an extremely rare variant of breast cancer. Presence of unequivocal squamous differentiation should be observed to diagnose a case as squamous cell carcinoma of breast since focal squamous metaplasia is frequently seen in common variants of breast carcinoma. We report here two cases of squamous cell carcinoma of breast, one a primary metaplastic type and the other one metastatic from a carcinoma of the cervix.

Proliferating Brenner tumour of ovary--a case report.

Transitional cell tumours or Brenner tumours of ovary are uncommon neoplasms. Out of all the Brenner tumours less than 2% are either proliferating or malignant type. Borderline or malignant tumours occur in women who are on an average 10 years older than those with benign tumours. It is essential to categorise these tumours as benign, borderline or malignant type as the biologic behaviour and choice of surgery differs in all of the three categories. The gross and microscopic findings of a proliferating brenner tumour are reported here.

Primary non-Hodgkin's lymphoma of the breast--a case report.

A 55 years female presented with a breast lump was diagnosed by cytology (FNAC) to be non-Hodgkin's lymphoma. Other pre-operative diagnostic procedures followed by post-operative biopsy examination were carried out. We report this case with discussion on diagnosis and special emphasis on cyto-diagnosis.