Pattern of Second Primary Malignancies in Thyroid Cancer Patients

Many factors; including relatively young age of thyroid cancer diagnoses and improved survival; have led to increased concerns about the occurrence of second primary malignancies. This paper describes the pattern of occurrence of second primary malignancies in patients who were treated for malignant thyroid neoplasms in an Indian hospital. There were 21 affected patients of the approximately 4500 seen over 25 years. Most of the second primary cancers are solid tumors; and when nonthyroid cancers are the second tumors; ductal carcinoma of the female breast is the most common. Most of these tumors have very short detection intervals (including synchronous occurrences); suggesting that therapy with internal radiation was not contributory to the tumor development. When thyroid malignancies were the second primary cancers; they usually follow radiotherapy to the head and neck region for treatment of the first primary tumor and tend to be of aggressive histologic types than the common well differentiated thyroid carcinomas

A rare H-type of tracheo-oesophageal fistula in a young boy.

A 9-year-old male child presented with features of recurrent episodes of pneumonia. Following administration of different types of antibiotics, resolution of pneumonia was not complete. Antituberculous drugs were given on two occasions for sufficient period of time without any improvement. Following admission, history of a choking sensation during taking food pointed to perform barium swallow examination of oesophagus which revealed the diagnosis of tracheo-oesophageal fistula.

Role of dilatation and curettage and interpretation of endometrial biopsy in gynaecological cases

310 Cases of diagnostic D and C were collected randomly from Gynae unit of Lady Reading Hospital Peshawar from January 1990 to January 1991. These were cases of infertility 49.26%, menorrhagia 13.22%, irregular bleeding 29.67%, Postmenopausal bleeding 5.164%, primary and secondary infertility 30.96% and 18.38% respectively. Various aspects like age, parity, marital status, clinical features and histopathological results were analysed 6.45% were below the age of 20 years. 63.22% between 21 to 40 years, 25.16% between 40-50 years and 5.16% were above the age of 50 years. 16.45% patients were nullipara. 15.48% Primipara and 37.09% and 30.96% were multipara and grand multipara respectively. 0.64% patients were un-married, 84.83% were married and 40.51% were widows. Results of endometrial biopsies were as follows. Proliferative phase 47.74%. Secretory phase 35.48%, tuberculous endometritis 1.93%, cystic endometrial hyperplasia 8.38%, Adenomatus hyperplasia 1.29% and adenocarcinoma 0.96%