Submental Artery Island Flap in Patients who Have Received Prior Neck Irradiation.

Submental Artery Flap (SMAF) was first described in 1990 and has gained popularity ever since. However there has been relative paucity on information about the use of this flap in irradiated patients. Our aim was to explore the success of SMAF for reconstructing defects following oral cancer resection in this group of patients After prior approval from scientific and ethical committee, we performed a retrospective review of records of eleven patients who underwent SMAF reconstruction between March 2009 and September 2012. Seven patients (63 %) had undergone prior irradiation . The flap was viable in all the patients excepting for superficial epidermal loss in one patient who had undergone prior irradiation. There was major donor site complication in one, and recurrences in four patients, all in the irradiated group. SMAF may be used in patients with irradiated neck taking special precautions to avoid donor site morbidity. Previous neck irradiation may not affect flap viability.

Adenosquamous carcinoma of vesicovaginal fistula: a rare entity.

A 56-year-old lady presented with a vesicovaginal fistula (VVF) along with past history of abdominal hysterectomy. Biopsy of the fistulous tract showed squamous cell carcinoma (SCC). Patient underwent radical cystourethrectomy, total vaginectomy, and bilateral pelvic lymph node dissection along with ileal conduit. The final histopathology report of the resected specimen showed adenosquamous carcinoma in VVF. As this is a rare entity, we are reporting this case.

Kikuchi-fujimoto disease as a differential diagnosis for cervical lymphadenopathy in India: a case report and review of literature.

Cervical Lymphadenopathy has a large list of differential diagnosis. In India, Tuberculosis and Malignant Neoplasms are the most common specific causes for cervical lymph node enlargement. Kikuchi-Fujimoto Disease (KFD), is an uncommon but increasingly reported cause, especially in Asia. Awareness of this condition amongst physicians leads to an accurate diagnosis without the need for expensive and often potentially harmful investigations. The disease is self limiting and responds well to symptomatic treatment.

Risk factors for lymph node metastasis in clinically node-negative penile cancer patients.

OBJECTIVES: To analyze the effects of pathological T stage, grade, extent of surgery for primary tumor, and age group on the risk of developing lymph node metastasis in clinically node-negative penile cancer patients. METHODS: We performed a retrospective analysis of 200 clinically node-negative penile cancer patients who were kept under surveillance, after treatment of the primary tumor in our institution. The primary outcome parameter was cytologically or histologically proven lymph node metastasis. Logistic regression analysis was used to compute odds ratios in univariate and multivariate settings. RESULTS: Lymph node metastasis occurred in 31 patients at a median time of three months. Histological grade 3 and grade 2 tumors had a statistically significant increased odds ratio for lymph node metastasis, (7.1[P < 0.001] and 2.7 [P = 0.04], respectively), compared with grade 1 tumors. Although increasing pT stage was associated with increasing odds ratios, the differences were not statistically significant. Nor did the extent of surgery of the primary tumor or the age group significantly influence the risk of developing lymph node metastasis. CONCLUSIONS: Histological grade is the most significant parameter influencing the risk of lymph node metastasis in clinically node-negative penile cancer patients on surveillance. Patients with grade 3 and grade 2 tumors may benefit from elective inguinal lymphadenectomy.