Association of leukemia and mitochondrial diseases-A review.

Mitochondria play an important role in various metabolic pathways like oxidative phosphorylation free radical generation and apoptosis. Defects in mitochondrial function are responsible for a number of heterogenous clinical presentations along with development and progression of cancer. Decrease in cellular energy (ATP) production because of impaired oxidative phosphorylation is the most important cause for these underlying disorders. The present review article aims to provide current understanding of mitochondrial genetics and biology and relates the mt-DNA alterations in leukemia patients.

Growing teratoma syndrome in primary mediastinal germ cell tumor: our experience.

BACKGROUND: Growing teratoma syndrome is a rare phenomenon seen in nonseminomatous germ cell tumors after chemotherapy, where the tumor grows paradoxically despite normalization of tumor markers. It has been found in various locations, most commonly, the retroperitoneum in association with metastatic disease. The occurrence of growing teratoma syndrome in a mediastinal primary is very rare and there are only a few reports in the literature. METHODS: In a retrospective review, out of 12 patients with mediastinal involvement by a germ cell tumor, 5 had a primary from the mediastinum. We present a series of 3 cases of primary germ cell tumor of the mediastinum, which after chemotherapy, fulfilled the criteria for growing teratoma syndrome and were managed with surgical excision. CONCLUSION: Development of growing teratoma syndrome in a primary mediastinal germ cell tumor is extremely rare. Its awareness and early detection can lead to successful surgical excision and long-term cure.

Malignant peripheral nerve sheath tumor of the thorax: Unusual location of a rare tumor.

Malignant peripheral nerve sheath tumor (MPNST) is a rare variety as sporadic tumor but more common when associated with neurofibromatosis, and its usual site of origin lies in the extremities. MPNST of thoracic cavity is a rare site of origin with only anecdotal reports in literature. Progression to a large size without distant metastases is even rarer owing to its high metastatic potential. We present a case of thoracic MPNST highlighting its rarity and the treatment options available to provide a best possible outcome.

Vasospasm following aneurysmal subarachnoid hemorrhage: Thrombocytopenia a marker.

BACKGROUND: Symptomatic vasospasm (SV) is often seen after aneurysmal subarachnoid hemorrhage (aSAH). The pathophysiology suggests that platelets initiate the process and are consumed. This is likely to result in thrombocytopenia. The objective of this study was to find out if thrombocytopenia preceded or followed SV and to analyze the relationship between the two. MATERIALS AND METHODS: The platelet counts of 74 patients were studied on day 1, 3, 5, 7, 9, 11, and 14 following aSAH. Clinical symptoms and raised velocities on transcranial Doppler were studied on the same days to determine SV. The relationship of platelet counts and SV were analyzed. RESULTS: Thirty-nine (52.7%) patients developed SV. Platelet counts dropped on postictal day (PID) 3-7 and SV was commonly seen on PID 5-9. The median platelet counts were significantly lower in patients with SV when compared to those without SV. Platelet count <150,000/mm(3) on PID 1 and 7 had statistically significant association (P < 0.001) with SV. The odds ratio was 5.1, 6.9, and 5.1 on PID 5, 7, and 9, respectively, for patients with relative thrombocytopenia (P < 0.001). CONCLUSIONS: There is a strong correlation between thrombocytopenia and SV. A platelet count < 150,000/mm(3) on PID 1 and 7 predicts presence of SV. The relative risk of developing SV is >5 times for a patient with relative thrombocytopenia especially on PID 5-9. Additionally, it appears that thrombocytopenia precedes vasospasm and may be an independent predictor. However, this requires further studies for validation.