Infantile Disseminated Bacille Calmette-Guérin Disease with Hemophagocytosis and Mimicking Juvenile Myelomonocytic Leukemia: A Case Report with Concise Literature Review.

Bacille Calmette-Guérin (BCG) is a live-attenuated vaccine routinely administered to newborns to prevent severe forms of tuberculosis (TB) in TB-endemic countries. Disseminated BCG vaccine disease is a classic feature of children with human immunodeficiency virus (HIV) or primary immunodeficiency disorders (PIDs) and is associated with high mortality. We report a case of a 6-month-old infant with disseminated BCG disease and hemophagocytic lymphohistiocytosis mimicking juvenile myelomonocytic leukemia with no demonstrable features of HIV or PID even after extensive laboratory work-up and succumbed to progressive disease. Disseminated BCG disease is a rare and potentially fatal complication of BCG vaccine, and prompt immunological evaluation complemented by initiation of 4-drug antitubercular therapy and definitive treatment with antiretroviral therapy or hematopoietic stem cell transplant is warranted.

A Glimpse into the Epidemiology of Geriatric Cancers in India: Report from the Indian Population Based Cancer Registries.

INTRODUCTION: Indian population is aging and the cancer rates are rising.  Older adults (OAs)(≥60 years) with cancer require specialized care.  However, data on geriatric cancer epidemiology is scarce. METHODS: The study compiled the geriatric cancer data from the published reports(2012-2014) of Indian population-based cancer registries(PBCRs). RESULTS: Of the 1,61,363 cancers registered in the Indian PBCRs, 72,446(44.9%) occur in OAs, with  21,805(30.1%), 18,349(25.3%), 14,645(20.2%), and 17,647(24.4%) occurring in 60-64, 65-69, 70-74, and ≥75year age groups.  The truncated incidence rates for OAs are 555.9,404.5, and 481.9 for males, females, and OA populations respectively.  The common cancers are lung, prostate, and esophagus cancers in males, breast, cervix, and lung in females.  The overall common cancers are lung, prostate, and breast.  While  >50% of the incident cases of prostate, and bladder cancers occurred in OAs, <20% of Hodgkin lymphoma and thyroid cancers occurred in OAs. OA cancer epidemiology has a regional variation, highest in South India and lowest in Western India. CONCLUSION: The current study quantifies the cancer burden in the Indian geriatric population. Understanding the epidemiology of geriatric cancers is vital to health program planning and implementation. Increased awareness, focused resource allocation, research, and national policies for streamlining care will all help to improve geriatric cancer outcomes.

First branchial cleft anomaly extending to parapharyngeal space.

First branchial cleft anomalies are quite rare, and the majority of them are found in and around the ear canal, mostly superficial to the facial nerve. Very rarely, the anomalous tract of the first branchial cleft can go deeper to the facial nerve, necessitating a meticulous and extensive surgery. A 21-year-old student presented with slowly increasing cystic swelling in the infra-auricular region. Findings of the magnetic resonance imaging were consistent with the first branchial cleft cyst, which also exhibited a deeper extent of the lesion into the parapharyngeal space. The entire tract was excised along with the superficial parotidectomy by an open approach. In addition to illustrating the presentation and management of this peculiar case, the present report also reviews the latest literature around their management.

Adult Neuroblastoma-Case Report and Literature Review.

Neuroblastoma is the most common solid malignant neoplasm in the paediatric age group; accounting for 7% of all childhood malignancies, but neuroblastoma in adult, is a rare occurrence, finding mention in aeons of medical literature with an overall incidence of 1 in 10 million adults/year. We report the case of a 24-year-old male patient presenting with the complaints of progressive abdominal distention of 2 months duration. Multiple Detector Computed Tomography (MD-CT) of abdomen revealed a huge enhancing mass in the retroperitoneum abutting the left kidney, and a subsequent CT-guided biopsy and immunohistochemistry confirmed the diagnosis of ganglioneuroblastoma. The patient was administered 3-cycles of neo-adjuvant chemotherapy with ifosphamide, carboplatin and etoposide (ICE-chemotherapy) and subsequently 3 more cycles of chemotherapy post surgery, followed by radiation. The rarity of this neoplasm in adults accounts for the lack of standardized staging and treatment protocols and the dismal prognosis even with aggressive multimodal treatment. We report this case because of its extreme rarity, and its tendency for capricious behavior.