ABSTRACT
Primary ectopic meningiomas of the nasal cavity are rare tumours and thus, often not diagnosed and treated properly. In this case report we are going to discuss about our experience with a primary nasal meningioma involving bilateral nasal cavity with its diagnosis, management and histopathological features. A 28 year old female presented with nasal obstruction and nasal discharge for the past 1 year and swelling over right side of face for the past 8 months. Patient underwent surgical resection by a combined endoscopic and external approach under general anaesthesia. Histopathological evaluation confirmed the diagnosis of Transitional meningioma WHO grade 1. A repeat nasal endoscopy done one week after surgery, showed no evidence of any residual tumour. Due to ectopic meningiomas being relatively less common one must always exclude the presence of a central meningioma, which makes radiological investigations a must in such cases. As primary extra-cranial meningiomas have an unpredictable behaviour, this study should further aid in diagnosis and management of these tumours.
ABSTRACT
Objectives: To quantify tumour size and margin shrinkage due to formalin fixation in head and neck cancer specimens and determine its effect on tumour staging and margin clearance. Methods: Tumour specimens were measured immediate post-resection and at 24 hours after fixation. Tumour was measured in 2 dimensions and one margin was measured. Shrinkage was categorised as < 10%, 10-20%, and > 20%. Effect of shrinkage on tumour stage and margin clearance were evaluated. Results: A total of 50 specimens were analysed. The tumour AP (Anterior Posterior) and SI (Superior Inferior) measurements showed significant shrinkage with a mean difference of 22.93% and 21.69% respectively. > 20% shrinkage was noted in 78% of AP and 58% of SI measurements. Margins showed a mean difference of 25.61%. 84% of margins demonstrated > 20% shrinkage. In all, 46.7% of T3 and 23% of T2 tumours pre-fixation were downstaged to T2 and T1, respectively, post-fixation. Conclusions: Formalin fixation alone can be responsible for significant shrinkage of tumour and margin dimensions in head and neck specimens. It is suggested that decisions regarding the treatment plan should be made on clinical staging of primary tumour rather than pathological staging. In addition, post-excision pre-fixation margins should be considered for treatment planning.
Subject(s)
Formaldehyde , Head and Neck Neoplasms , Humans , Tissue Fixation/methods , Head and Neck Neoplasms/surgery , Margins of Excision , Neoplasm StagingABSTRACT
PURPOSE: Patients with malignancy quite often suffer from physical as well as psychological symptoms due to the shattering diagnosis, and prolonged, incapacitating management. The frequency of the depressive disorder in malignancy is around 8-40%. The present study aims at analysing the socio-demographic profile and magnitude of depressive disorders in patients with malignancy. METHODS: A cross-sectional study was conducted in malignancy patients attending an Ear Nose Throat department using the PHQ-9 questionnaire. RESULTS: Total PHQ-9 score ranged from 0 to 19; the mean score was 8.46. Major depressive disorder was seen in 4 (8%) cases, while other depressive disorder occurred in 22 (44%) cases. Mild severity of symptoms was noted in 15 (30%) of the patients. High statistical significance was noted between PHQ-9 score for MDD and other depressive disorder (p value < 0.001). CONCLUSION: The profile of depressive disorders in malignancy varies; PHQ-9 can be used as a good tool for early detection.
