A novel case of left atrial and right lung mass turned out to be unconventional metastasis of uterine leiomyosarcoma with a review of literature

Uterine leiomyosarcoma (ULMS) is a rare malignancy arising from the myometrial smooth muscle wall, and cardiac metastases are extremely rare. Metastasis to the heart is a very unusual finding, and atrial metastasis is even rarer. Here, we report a case of a 45 year old woman who presented with dyspnea and pleural effusion and had a significant history of hysterectomy done for ULMS. Magnetic resonance imaging revealed a left atrial mass, which was resected and revealed to be a metastasis of leiomyosarcoma on histopathology and immunohistochemistry. Metastatic ULMS may rarely present as a left atrial mass with acute clinical presentation. Detailed clinical history and accurate diagnosis are vital for further management.

Study to assess the pathophysiological role of VEGF in patients with chronic myeloid leukemia(CML) .

Background: VEGF play a significant role in the pathogenesis of chronic myeloid leukemia. Aims & Objective: (1) Assess the pathophysiological role of VEGF in patients with chronic myeloid leukemia (CML). (2) Study the effect of Hydroxyurea and Imatinib on serum VEGF level. Material and Methods: A total of 40 cases of chronic myeloid leukemia (CML) and 20 age and sex matched healthy controls were included in this study. The patients were divided into 3 subcategories: Untreated cases (which did not receive any treatment); patients who were treated with Hydroxyurea and patients who were treated with Imatinib Mesylate. 5 ml of blood was collected, were centrifuged at 5000 rpm for 10 minutes and stored at - 20°C until assay. Results: On comparing the various subgroups with control, the value was 726.61 ± 199.67 pg/ml in untreated group. It was 573.53 ± 213.423 pg/ml in Hydroxyurea group and 530.00±180.96 pg/ml in Imatinib group. Fresh cases had significantly elevated VEGF value (P value < 0.001). VEGF level significantly elevated in Untreated cases when compared to treated groups either hydroxyurea (p=0.02) or Imatinib (p=0.019). There was no significant difference between Hydroxyurea and Imatinib groups. Conclusion: This study suggests that VEGF play a significant role in the pathogenesis of chronic myeloid leukemia. Understanding this may help in designing new therapeutic strategies (antiangiogenic agents) for this dreaded disease.

An outbreak of viral hepatitis in Jodhpur city of Rajasthan.

An outbreak of Viral hepatitis occurred in Jodhpur city of Rajasthan during April to June, 1994. The attack rate was 3.04 per cent among 0-14 years age group and 5.49% among the age group above 15 years, the overall attack rate being 4.5 per cent. Males were more affected than females. Epidemiological and serological findings suggest that the outbreak was due to enterically transmitted Non A Non B virus. The source of infection was drinking water contaminated with sewage.