ABSTRACT
Omphalolith (Umbolith) is uncommon under normal circumstances. However in a deeply retracted umbilicus in an obese individual, accumulation of sebum and keratin may lead to the formation of a stone. This calculus may remain undiagnosed for many years until revealed by secondary infection or ulceration.We report an intersting case of omphalolith in an elderly woman.
ABSTRACT
BACKGROUND: One of the most distressing complications of head and neck cancer patients on chemoradiotherapy is mucositis. There is no proper tool to predict its occurrence in these patients. AIM: This study was conducted to develop a risk-scoring system to predict probable incidence and severity of mucositis in head and neck cancer patients on chemoradiotherapy. MATERIALS AND METHODS: This is a retrospective analysis conducted at a tertiary care cancer center with approximately 2,000 new cases of head and neck cancer patients annually. We Hypothesized were age, comorbid conditions, leukocyte count, nutritional status, oral hygiene, tobacco use, erythrocyte sedimentation rate (ESR); Eastern cooperative oncology group (ECOG) performance status (PS) and TNM (tumor, node, metastasis) stage as possible risk factors. Receiver operating characteristic (ROC) curves were drawn to predict the cutoff values for risk factors, and a final scoring system was developed with sensitivity and specificity data. RESULTS: A total of 218 patients on chemoradiation receiving cisplatin 40 mg/m2 /week along with local radiation of 60-70 Gy depending on primary site were analyzed. Based on ROC analysis, the following cutoff values were selected: age > 40 years, ECOG PS > 2, WBC < 3000/µL, elevated ESR, albumin < 3 gm/dL and > stage III disease. The remaining factors were indicated as present or absent. A score of 1 was assigned for the above risk factors. For patients, the final score of 3 or less there is 17% probability of developing grade 3 or 4 mucositis, while patients having score of 6 or more have 76% probability. CONCLUSION: The current tool is fairly accurate in predicting development of mucositis in head and neck cancer patients on chemoradiotherapy. This will further help clinicians to adopt preventive strategies as well as better counseling.
Subject(s)
Antineoplastic Agents/adverse effects , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Mucositis/etiology , Combined Modality Therapy , Head and Neck Neoplasms/complications , Humans , ROC Curve , Radiotherapy/adverse effects , Retrospective Studies , Risk AssessmentABSTRACT
OBJECTIVE: A variety of preoperative variables-such as perforation prior to surgery, poor nutritional status, and comorbid conditions such as diabetes-are already known to shorten relapse-free survival in patients with gastrointestinal malignancies. However, the significance of postoperative events in gastrointestinal malignancies is still debated and has not been studied in the population of southern India. METHODS: A retrospective study was conducted at Kidwai Memorial Institute of Oncology, Bangalore, India, from September 2004 to 2006. Patients from a single surgical unit who had undergone surgery with curative intent for gastrointestinal malignancies were evaluated (to maintain uniformity, patients who had undergone palliative surgery were not included in the analysis). We assumed anastomotic leak, delayed wound healing, and postoperative weight loss > 10% as risk factors predictive of poor disease-free survival. These factors were evaluated in all patients, and risk for development of relapse was calculated. RESULTS: A total of 236 patients were evaluated. Baseline parameters were similar in both groups. Compared with patients who developed no postoperative complications, we found that the risk of relapse is 9.8 times greater in patients having anastomotic leak, 8.2 times greater in those with delayed recovery, and 2.3 times greater in those having excessive weight loss. The risk was uniform in all types of gastrointestinal malignancies. CONCLUSION: The results suggest that anastomotic leak, delayed wound healing, and postoperative weight loss in patients with gastrointestinal malignancies confer poor disease-free survival. The presence of these complications warrants closer follow-up and management as appropriate.
ABSTRACT
A 46-year-male smoker presented with cough and fever to a chest physician, who on the basis of chest X-ray started him on antitubercular treatment. However, further evaluation suggested that the patient was suffering from a rare disease, i.e. Anaplastic large cell lymphoma of lung. Although lung involvement in cases of lymphoma is observed in as high as 40% of cases, in autopsy series, the exact clinical incidence is not known. One of the largest lymphoma groups reported it to be around 25%. However, primary pulmonary lymphomas have been extremely rare (0.4%), and whenever present they are of (Mucosa Associate Lymphoid tissue) MALT type, with occasional diffuse large cell lymphomas. The anaplastic variant is extremely uncommon. Usually the treatment results are satisfactory with more than 80% of the cases surviving even after 3 years. Here we report the case of anaplastic primary nonHodgkin's lymphoma of lung and review the literature.
