Young onset colorectal cancer: How does it differ from its older counterpart.

BACKGROUND: Colorectal cancer in the young has been a debated topic in literature with conflicting reports as to its pattern of occurrence and survival as compared to the older age group. MATERIALS AND METHODS: Retrospective study to analyze the clinicopathological characteristics, treatment modalities and survival of sporadic young‑onset colorectal cancer (YOCR) patients (<40 years) and compare them with the older group (>40 years). RESULTS: Of 172 patients managed, 72 (42%) were in the YOCR group. Among 72 patients, six were excluded because of hereditary syndromes. Incontinence (P = 0.02) and obstruction at time of presentation (P = 0.03) was significantly more common in the YOCR group. Left sided disease was more common in YOCR group (47/66) compared to the older group (65/100), but the difference was not statistically significant (P = 0.45). The proportion of rectal cancers was significantly more in the YOCR group (39/47) compared to the older group (39/65) (P = 0.01). Significant difference in resectability was noted in the left sided (YOCR 26/47 vs. older 49/65 P = 0.04) and the rectal cancers (YOCR 18/39 vs. Older 29/39 P = 0.02). The survival was similar among the two groups. CONCLUSIONS: Sporadic colorectal cancers in the young are more advanced and less resectable when compared to older population. Genetic studies are needed to elaborate the reasons for left sided predominance and aggressiveness of sporadic colorectal cancers in the younger subgroups.

Osteopetrosis: A rare cause of anemia - Review of literature.

Normocytic anaemia is caused either by hypoproliferation of haemopoietic tissue or increased destruction of red cell. Osteopetrosis is a rare cause of anaemia. The leading clinical features are pallor, growth failure, hepatosplenomegaly.On hematological examination, anemia, thrombocytopenia, leucocytosis and myelophthisic anemia are commonly observed in this disease. We are highlighting osteopetrosis as a rare cause of anemia presenting to us for evaluation of anemia.

Disseminated histoplasmosis with reactive haemophagocytosis presenting as PUO in an immunocompetent host.

Disseminated histoplasmosis (DH) with reactive haemophagocytosis has been described in literature mainly in immunocompromised hosts. Only sporadic case reports exist in immunocompetent hosts. Here, we present a rare case of DH with reactive haemophagocytosis in an immunocompetent host presenting as PUO.

Chemotherapy-induced palmer planter erythrodysesthesia.

We report a case of palmar plantar erythrodysesthesia (PPE) in a case of acute lymphoblastic leukemia treated with VALP regime. The treating physician must be aware of this uncommon complication of chemotherapeutic agents to avoid unnecessary investigations.

Congenital hypofibrinogenemia.

Congenital afibrinogenemia/hypofibrinogenemia is an extremely rare coagulation disorder. We describe a case of congenital hypofibrinogenemia in a 6-year female child, who presented with recurrent ecchymotic spots with no frank bleeding.

Solitary calvarial metastases: an unusual presentation of thoracic neuroblastoma.

A primary thoracic origin occurs only in 20% of neuroblastomas, and their classical presentation is mediastinal or cord compression. Skeletal metastases of neuroblastomas are characteristically multiple, and calvarial deposits usually show simultaneous involvement of orbit. Solitary metastases in neuroblastoma, is an unusual entity and its presentation as a large calvarial mass, especially from a thoracic primary, is rare. Furthermore, calvarial metastases are relatively uncommon in children compared to adults. We discuss the clinical, radiographic, CT features, and differential diagnosis of a large calvarial mass with sunray spiculation in a child, which was due to a solitary metastases from an occult thoracic neuroblastoma. The possibility of neuroblastoma presenting in this unique fashion and the importance of considering a chemosensitive tumor such as neuroblastoma in the differential diagnosis of a solitary calvarial mass in a child is highlighted by our report.

Tuberculous mainstem bronchostenosis in a ten-year-old girl.

Tuberculous bronchostenosis involving the main bronchus is rare in children. We describe a 10-year-old girl who developed left mainstem tuberculous bronchostenosis inspite of effective and adequate chemotherapy for which she underwent a left pneumonectomy.

Small cell lung cancer presenting as Cushing's syndrome.

A rare case of small cell carcinoma of the lung who presented with Cushing's syndrome and superior vena cava syndrome is described. The relevant literature is reviewed.

Prevalence & clinical associations of anticardiolipin antibodies in patients with systemic lupus erythematosus in India.

Anticardiolipin antibody (aCL) screening using an ELISA technique, in 76 patients of Indian origin with systemic lupus erythematosus (SLE), showed aCL in 27.63 per cent of patients. This prevalence was much lower than that reported in the Western population. The presence of aCL showed positive correlations with recurrent abortions and organic neurological lesions seen in SLE.