Isolated acrometastasis: A rare presenting feature of endometrial carcinoma

The most common presenting feature of endometrial carcinoma (EC) is abnormal uterine bleeding. Bone metastasis, as a presenting feature of EC, is very unusual which is usually restricted to pelvis and vertebrae. The occurrence of foot metastasis is exceedingly rare. We report a case of a postmenopausal female presented with pain and swelling involving right foot. Biopsy revealed metastatic adenocarcinoma. The patient denied any history of vaginal bleeding or other gynecological symptoms. Bone scan suggested increased uptake in multiple tarsal bones. Uterine curettage confirmed the diagnosis of endometrial adenocarcinoma. The patient was successfully treated with debulking surgery, palliative radiotherapy to the right foot, bisphosphonates, and systemic chemotherapy with marked improvement in local symptoms and is under follow-up for the last 6 months after completion of the treatment. An extensive review of the literature, to the best of our knowledge, did not reveal many cases of acrometastasis as a presenting feature of EC

Secondary Malignancies Developing After Acute Lymphoblastic Leukemia And Its TreatmentWith Constitutional Mismatch Repair Deficiency Syndrome In Siblings.

Background & Objectives: Acute Lymphoblastic Leukemia (ALL) is the most common childhood malignancy, with an annual rate of 3 to 4 cases per 1,00,000 children. ALL patients are treated with chemotherapeutic agents and cranial irradiation. Long-term sequelae of treatment are impaired intellectual and psychomotor functioning, neuroendocrine abnormalitites, impaired reproductive capacity, cardiotoxicity and second malignant neoplasms are being reported with increased frequency in the survivors. Among second neoplasms observed after treatment of ALL, central nervous system (CNS) tumors in patients treated with cranial irradiation are the most common. Others are Lymphoma, Acute Myeloid Leukemia (AML) and Thyroid Cancer. Methodology & Results: We are reporting four cases ,who developed ALL at the age of 8,6,4 and 25 years respectively(among that case 1 & case 2 are siblings) and were treated with chemotherapy and cranial irradiation. They developed Astrocytoma Grade-4 , Alveolar Soft-Part Sarcoma(ASPS) , Anaplastic Large Cell Medulloblastoma & Ewing’s Sarcoma at, 12 , 15, 8, 12 & 26 years of age respectively. Conclusion: Oncologists should make sure about the radiation doses before starting treatment and they should keep CMMR-D as a possibility in pediatric patients with siblings having h/o malignancy.