Revisiting Cancer Cachexia: Pathogenesis, Diagnosis, and Current Treatment Approaches.

The objective of this article is to group together various management strategies and to highlight the recent treatment modifications that attempt to target the multimodal etiological factors involved in cancer cachexia. The contemporary role of nursing fraternity in psychosocial and nutritional assessment of cancer patients is briefly discussed. Cachexia is a syndrome of metabolic disturbance, characterized by the inflammation and loss of muscle with or without loss of adipose tissue. In cancer cachexia, a multifaceted condition, patients suffer from loss of body weight that leads to a negative impact on the quality of life and survival of the patients. The main cancers associated with cachexia are that of pancreas, stomach, lung, esophagus, liver, and that of bowel. The changes include increased proteolysis, lipolysis, insulin resistance, high energy expenditure, and reduced intake of food, all leading to impaired response to different treatments. There is no standardized treatment for cancer cachexia that can stabilize or reverse this complex metabolic disorder at present. The mainstay of cancer cachexia therapy remains to be sufficient nutritional supplements with on-going efforts to explore the drugs that target heightened catabolic processes and complex inflammation. There is a need to develop a multimodal treatment approach combining pharmacology, exercise program, and nutritional support to target anorexia and the severe metabolic changes encountered in cancer cachexia.

A rare case of long-standing mucoepidermoid carcinoma of minor salivary glands of the palate.

Salivary gland carcinomas are the uncommon and clinically diverse group of neoplasms with mucoepidermoid carcinoma (MEC) being the most common among them. MEC accounts for 5% of all salivary gland tumors. As the name implies, the tumor is composed of both mucus secreting cells and epidermoid type cells in varying proportions. Most patients are aware of the lesion for 1 year or less. We report clinical, radiographic and histological features of a long-standing case of mucoepidermoid carcinoma of minor salivary glands of the palate in a 35-year-old male patient. The patient reported with a slow growing swelling on the palate which began 15 years ago. The patient was treated with hemi-maxillectomy and is currently under follow up.

A Rare Clinical Presentation of an Osteochondroma of Coronoid Process of Mandible.

Osteochondroma (osteocartilaginous exostosis) is one of the most common benign tumors of bone but is rare in the craniofacial region. Only a few cases of osteochondroma of the coronoid process have been reported in the literature, since the time of its discovery (osteochondroma of a coronoid process) by Jacob in 1899. We present a case of osteochondroma of the left coronoid process in a 16-year-old female patient. Contrary to the literature, our patient had no limited mouth opening despite a close approximation of left hyperplastic coronoid process with zygomatic arch, making it a unique case among similar cases. Plain radiography can be used for this hyperplastic condition but due to its inherent distortion and being only two-dimensional (2D) it has a limited diagnostic advantage. Cone beam computed tomography (CBCT) was employed for necessary diagnostic information. We managed our patient with an intraoral coronoidectomy.