Primary fallopian tube carcinoma with metastasis in the contralateral ovary.

Primary malignant neoplasm of the fallopian tube is one of the rarest gynaecological malignancies and a pre-operative diagnosis is often missed due to its diagnostic confusion with the tubo-ovarian mass, hydrosalpinx, ectopic pregnancy and ovarian malignancy. Transcoelomic, lymphatic, transluminal and haematogenous spread may occur to the other abdominal and pelvic organs as well as to the distant sites. Though the body of the uterus, ovaries and the contralateral fallopian tube are frequently involved, in the present case the contralateral ovary was the only site of involvement which is very unusual.

Symptomatic vertebral hemangioma: treatment with radiotherapy.

BACKGROUND: Vertebrae are the second commonest site among skeletal locations affected by hemangioma, but only about one per cent becomes symptomatic throughout the life. Though surgery, intra vertebral injection of various sclerosing agents have been tried in treating this benign process, no general consensus regarding management has been reached. Radiotherapy is emerging as a low cost, simple, non-invasive but very effective modality of treatment of symptomatic vertebral hemangioma. AIM: This study aims to find out the role of external beam radiotherapy in alleviating the symptoms of symptomatic vertebral hemangiomas without compromising the quality of life. MATERIALS AND METHODS: Seven consecutive patients with symptomatic vertebral hemangioma were treated with a fixed dose of external beam radiotherapy; and muscle power was assessed before, after treatment and during follow-up. RESULTS: All patients showed improvement of muscle power, which increased with the passage of time. Pain relief with improvement of quality of life was obtained in all the patients. CONCLUSION: Effect of radiotherapy on vertebral hemangioma is dose-dependent and the dose limiting factor is the spinal cord tolerance. In the present era of IMRT, greater dose can be delivered to the parts of vertebra affected by the hemangioma without compromising the spinal cord tolerance and expected to give better results.

Preoperative ultrasound guided needle localisation for non-palpable breast lesions.

BACKGROUND: Breast cancer is a major cause of cancer-related morbidity and mortality in Indian women. Most cases present late and thus survival in Indian patients is poor compared to the western world. In the absence of a screening, early detection of breast cancer is a challenge in Indian subcontinent. METHOD: Though much is known about management of any palpable lump in breast, clear guidelines in dealing with non-palpable lesions of breast is still obscure. Careful imaging of breast followed by assignment of standard Breast Imaging Reporting and Data Systems (BIRADS) category to the finding can go in a long way to predict chances of malignancy in a non-palpable breast lesion (NPBL). Total 22 patients with impalpable lesions in the breast were localised with US guided needle and lesion excised. Applicability of Ultrasonography (USG) to detect early breast lesions and comparison with mammography in predicting malignancy was assessed by tests of proportions (z test). RESULTS: Total of three early breast cancers and four borderline lesions were diagnosed by this method among 22 properly selected cases. Needle localisation of the lesion on sonographic guidance followed by lumpectomy can be both an accurate diagnostic and therapeutic method to deal with occult lesion in our scenario. CONCLUSION: US guided lumpectomy is a feasible alternative to other methods and is effective in Indian scenario to diagnose early subclinical breast cancers.