Retrospective Audit of Various Surgical Modalities Adopted for Giant Cell Tumor in a Rural Tertiary Cancer Center.

Giant cell tumor of bone (GCTB) is a rare tumor with a spectrum of clinical behavior. Standard treatment modalities include surgical curettage to wide resection, and varying oncological and functional results have been reported. The aim of this study was to evaluate the functional outcome and recurrence rates of patients who underwent surgery for giant cell tumor in a rural tertiary cancer center from June 2009 to December 2016. A retrospective review of 12 patients (7 males and 5 females) with GCT of the extremity bones treated in the institution between the period of June 2009 and December 2016 was performed to study the oncological and functional outcomes. All patients were evaluated by clinical examination, plain X-ray of local parts, X-ray of the chest, and MRI of local parts. A biopsy was taken in all cases to confirm the diagnosis. All patients underwent surgical treatment including curettage combined with cryosurgery and bone cement or wide resection and reconstruction. Selection of the surgical technique was based on the site and size of the lesion, soft tissue involvement (intra- or extra-compartmental), and if recurrent or not. The patients were followed up to April 2018. The mean age of the patients was 31.3 years. The tumor sites were distal femur in 3 cases, proximal tibia in 6, ischial bone in 1, distal radius in 1, and 1 in the metacarpal bone. Campanacci radiographic grading was grade1 in 3 cases, grade 2 in 2 cases, and grade 3 in 7 cases. Out of 12 patients, local recurrence was noted in 2 patients (16.7%). Functional evaluation was performed according to the Musculoskeletal Tumor Society Scoring (MSTS) system. Mean MSTS score was 25. To preserve the good function of the extremities and avoid local recurrence, we consider that curettage with adjunctive therapy such as polymethylmethacrylate (PMMA) and liquid nitrogen should be employed for the treatment of benign GCT of bone. Wide excision should be considered for large tumors where achieving oncological results with functional preservation would be difficult with curettage procedure.

Osteonecrosis of the Jaw among Patients Receiving Antiresorptive Medication: A 4-year Retrospective Study at a Tertiary Cancer Center, Kerala, India.

PURPOSE: Osteonecrosis of the jaw (ONJ) is a rare but complicated side effect of antiresorptive medications. The aim of the study is to evaluate the dental and drug-related factors related to ONJ among patients on these drugs at a tertiary cancer center, India. METHODOLOGY: A retrospective record review of patients who received antiresorptive medication at our center from 2011 to 2014 was done. The demographic factors, type, dosage, and duration of the medication and dental history were collected, and the data were entered an analyzed using Epidata software. RESULTS: A higher incidence of ONJ (8.1%) was noted in our sample (n = 183). Dental intervention after zoledronic acid (ZA) administration showed a statistical significance (P < 0.001). No significance (P value) was noted with respect to sex (0.78), age (0.28), median duration (0.9), and median dosage (0.9) of ZA. CONCLUSION: Oro-dental screening and dental monitoring shall reduce the incidence of ONJ. Within the limitations of our study, no significant relation could be pointed toward the dosage and duration of the drug and development of ONJ.

Validation of Malayalam Version of National Comprehensive Cancer Network Distress Thermometer and its Feasibility in Oncology Patients.

CONTEXT: This study was designed to translate and validate the National Comprehensive Cancer Network (NCCN) distress thermometer (DT) in regional language " Malayalam" and to see the feasibility of using it in our patients. AIMS: (1) To translate and validate the NCCN DT. (2) To study the feasibility of using validated Malayalam translated DT in Malabar Cancer center. SETTINGS AND DESIGN: This is a single-arm prospective observational study. The study was conducted at author's institution between December 8, 2015, and January 20, 2016 in the Department of Cancer Palliative Medicine. MATERIALS AND METHODS: This was a prospective observational study carried out in two phases. In Phase 1, the linguistic validation of the NCCN DT was done. In Phase 2, the feasibility, face validity, and utility of the translated of NCCN DT in accordance with QQ-10 too was done. STATISTICAL ANALYSIS USED: SPSS version 16 (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.) was used for analysis. RESULTS: Ten patients were enrolled in Phase 2. The median age was 51.5 years and 40% of patients were male. All patients had completed at least basic education up to the primary level. The primary site of cancer was heterogeneous. The NCCN DT completion rate was 100%. The face validity, utility, reliability, and feasibility were 100%, 100%, 100%, and 90%, respectively. CONCLUSION: It can be concluded that the Malayalam validated DT has high face validity, utility, and it is feasible for its use.

Bleomycin induced urethral stricture in Hodgkin's disease.

Bleomycin is a glycoprotein that is extensively used in combination with other anti-cancer agents because of its relative lack of hematological and gastrointestinal toxicity. However, pulmonary toxicity is common with bleomycin and limits its therapeutic utility. Urethral stricture as a result of bleomycin toxicity has not been reported in literature. In this case report, a young male patient who developed urethral stricture after bleomycin-based chemotherapy is described and the possible effects of bleomycin on the urethra are discussed.

Postoperative renal failure following inferior vena caval tumor resection with right nephrectomy: A case report and review of literature.

Tumors arising from the inferior vena cava are rare. The commonest histological type among these rare tumors is leiomyosarcoma. Complete resection of the tumor is the mainstay of management. Concomitant right nephrectomy during resection may be required. As the collateral circulation of the left renal veins is extensive and well-developed, reconstruction of left renal vein is not required generally. This case report provides a situation, which may warrant the reconstruction of the left renal vein as the patient developed postoperative renal failure. Authors recommend the reconstruction of the left renal vein in a similar situation disregarding the collateral circulation.

Oral cavity metastasis: An unusual presentation of carcinoma prostate.

Oral cavity cancers form the third most common cancers among men in south India. The oral cavity is a very rare site for metastases and has been described in various cancers, particularly lung, breast, kidney and colon carcinoma. Here a very rare case of a buccal metastasis from prostate carcinoma that was originally evaluated as a primary oral cavity malignancy is presented. Histopathological examination of a biopsy of the lesion revealed papillary adenocarcinoma Grade II, nuclear Grade II, which initiated the evaluation of prostate. On evaluation diagnosis of carcinoma prostate was made which was confirmed by immunohistochemistry for PSA.

Penile metastasis from rectal carcinoma.

Penile metastases are infrequent and often originate from genitor-urinary organs including bladder and prostate. In the present communication, we report an unusual case of penile metastasis from rectal adenocarcinoma. Though uncommon, this presentation is not unknown. A review of literature of penile metastases in colorectal cancers is also summarized here.

A simple method to take urethral sutures for neobladder reconstruction and radical prostatectomy.

For the reconstruction of urethra-vesical anastamosis after radical prostatectomy and for neobladder reconstruction, taking adequate sutures to include the urethral mucosa is vital. Due to the retraction of the urethra and unfriendly pelvis, the process of taking satisfactory urethral sutures may be laborious. Here, we describe a simple method by which we could overcome similar technical problems during surgery using Foley catheter as the guide for the suture.

The use of polarized laser light through the eye for noninvasive glucose monitoring.

BACKGROUND: In order to optimally manage diabetes mellitus, it is recommended blood glucose levels be monitored several times daily so an appropriate action can be taken to maintain tight control of these levels within a normal physiological range. All commercially available devices to measure blood glucose concentrations require the extraction of a drop of blood, normally obtained via the lancing of a finger. The main drawback to this method is the pain, often leading to low patient compliance. Therefore, a noninvasive glucose sensing method would greatly facilitate the management of diabetes. METHODS: In this article, we describe in vitro and in vivo results from a laser-based optical polarimetry system using the anterior chamber of the eye as a potential method to noninvasively monitor glucose levels in the body. RESULTS: It is shown, in vitro, that glucose can be predicted in the presence of albumin at physiological levels and, through the use of a novel light coupling mechanism, it is demonstrated that a polarimetric signal can be detected, in vivo, through a rabbit eye. CONCLUSIONS: Although the commercial production of a feasible noninvasive glucose monitoring method is still years away, laser-based polarimetry remains a viable alternative due to its potential to extract concentration information using the eye as a unique optical window into the body.