Journal of Cancer Research and Therapeutics
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Item Polymorphous adenocarcinoma of the buccal space—Rare, reported case from our institute(Wolters Kluwer – Medknow, 2024-09) Sidhu, Manjinder Singh; Gupta, Sumit; Kane, Shubhada; Paul, DavinderPolymorphous adenocarcinoma (PAC) of head and neck tumors is a rare salivary gland neoplasm of indolent course. We reported a 63?year?old female who presented as an asymptomatic mass in buccal space. The patient, after metastatic workup, underwent complete excision of the lesion with a negative margin. Postoperative histopathology and immunohistochemistry (IHC) were suggestive of PAC. Presently patient is on follow?up as per a multidisciplinary team decision. To conclude, PAC diagnosis is challenging due to morphological diversity, which necessities IHC. In addition, presently treatment of choice as per the literature review is complete excision.Item Adrenal ganglioneuroma with retroperitoneal lymph node metastasis: A rare scenario(Wolters Kluwer – Medknow, 2024-09) Kamboj, Meenakshi; Gupta, Gurudutt; Pasricha, Sunil; Sharma, Anila; Durga, GarimaGanglioneuroma (GN) is the most differentiated and benign variant of neuroblastic tumors, most commonly located in the posterior mediastinum, followed by the retroperitoneum and adrenal gland. Children of <10 years of age are more commonly affected than adults. Though benign, GNs can very rarely metastasize to regional lymph nodes or distant sites like liver, bone, spleen, and soft tissues. Metastatic lesions are assumed to represent neuroblastomas in which the metastasis and the primary tumor, both have matured. This differentiation can occur spontaneously or after treatment. We present a primary ganglioneuroma of adrenal gland in a 4?year?old child with nodal metastasis, without any blastemal component at any site.Item Novel swing lock denture design utilizing magnets for a patient with mandibular resection(Wolters Kluwer – Medknow, 2024-09) Jing, Kweh T.; Buzayan, Muaiyed M. A.Mandibular defects requiring reconstructions may result from mandibular resections due to benign or malignant lesions. Prosthesis?based rehabilitation of such cases represents a challenge due to various anatomical and functional limitations. Here we present a novel design for the fabrication of a swing lock denture utilizing a simplified hinge and magnets for a patient who had undergone hemimandibulectomy.Item Mammary analogue secretory carcinoma involving submandibular gland: Diagnostic pitfall with review of literature(Wolters Kluwer – Medknow, 2024-09) Dhankar, Nimisha; Verma, Nidhi; Agarwal, Abhinav; Mehar, Ravi; Pasricha, SunilMammary analogue secretory carcinoma (MASC) is a recently defined entity among salivary gland tumors. MASC bores a striking resemblance to secretory carcinoma of breast along with the characteristics of ETV6–NTRK3 translocation. Hence, the entity was designated as MASC and was formally included in the 4th edition of World Health Organization classification of head and neck tumors in 2017. To the best of our knowledge, around 12 cases of MASC have been described in the Indian literature. MASC commonly involves parotid gland (70%). Involvement of submandibular gland is still rarer (7%). Prognosis of MASC is comparable to other low grade salivary gland malignancies; however, aggressive behavior has also been reported in few cases. This case is one of the very few reported cases describing MASC with detailed clinical, cytology, and microscopy findings along with special stains and immunohistochemistry.Item Application of computed tomography-based radiomics analysis combined with lung cancer serum tumor markers in the identification of lung squamous cell carcinoma and lung adenocarcinoma(Wolters Kluwer – Medknow, 2024-08) Zhang, Tongrui; Li, Jun; Wang, Guangli; Li, Huafeng; Song, Gesheng; Deng, KaiObjective: To establish a prediction model of lung cancer classification by computed tomography (CT) radiomics with the serum tumor markers (STM) of lung cancer. Materials and Methods: Two?hundred NSCLC patients were enrolled in our study. Clinical data including age, sex, and STM (squamous cell carcinoma [SCC], neuron?specific enolase [NSE], carcinoembryonic antigen [CEA], pro?gastrin?releasing peptide [PRO?GRP], and cytokeratin 19 fragment [cYFRA21?1]) were collected. A radiomics signature was generated from the training set using the least absolute shrinkage and selection operator (LASSO) algorithm. The risk factors were identified using multivariate logistic regression analysis, and a radiomics nomogram based on the radiomics signature and clinical features was constructed. The capability of the nomogram was evaluated using the training set and validated using the validation set. A correction curve and the Hosmer?Lemeshow test were used to evaluate the predictive performance of the radiomics model for the training and test sets. Results: Twenty?nine of 1234 radiomics parameters were screened as important factors for establishing the radiomics model. The training (area under the curve [AUC] = 0.925; 95% confidence interval [CI]: 0.885–0.966) and validation sets (AUC = 0.921; 95% CI: 0.854–0.989) showed that the CT radiomics signature, combined with STM, accurately predicted lung squamous cell carcinoma and lung adenocarcinoma. Moreover, the logistic regression model showed good performance based on the Hosmer?Lemeshow test in the training (P = 0.954) and test sets (P = 0.340). Good calibration curve consistency also indicated the good performance of the nomogram. Conclusion: The combination of the CT radiomics signature and lung cancer STM performed well for the pathological classification of NSCLC. Compared with the radiomics signature method, the nomogram based on the radiomics signature and clinical factors had better performance for the differential diagnosis of NSCLC.Item Jumping translocation of 3q21 in a patient with acute myeloid leukemia and poor clinical outcome(Wolters Kluwer – Medknow, 2024-09) Belnekar, Mamta; Virulkar, Shital; Tulpule, Sameer; Kar, BibhasJumping translocation (JT) is a cytogenetic event in which a donor chromosomal segment is translocated to two or more recipient chromosomes. We describe a case of a 75?year?old female patient diagnosed with acute myeloid leukemia (AML) with monocytic differentiation having acquired JT involving 3q21?3qter as a donor chromosomal segment with 12 different recipient chromosomes. Each abnormal clone had monosomy 7 and trisomy 8. Patients with JT have an adverse outcome, a high risk of disease progression, and an unfavorable prognosis. This is the sixth case of JT involving 3q21 and the first case having 12 different recipient chromosomes (15 chromosomal segments) along with monosomy 7 in all abnormal clones reported in the literature.Item Bifocal intracranial germ cell tumor: A diagnostic and therapeutic dilemma for radiation oncologists(Wolters Kluwer – Medknow, 2024-09) Antony, Varghese; Pahuja, Anjali K.; Sethi, Jaskaran S.; Suresh, TamilarasuAn eight?year?old child presenting with increased thirst, raised intracranial tension and visual deterioration was diagnosed with synchronous suprasellar and pineal lesions, for which she underwent partial resection of the suprasellar lesion. Histopathological examination suggested pure germinoma. Tumor marker evaluation showed significantly raised levels of beta human chorionic gonadotropin (?HCG), favoring a non?germinoma germ cell tumor (NGGCT), leading to a diagnostic dilemma as the histology and ?HCG levels were contradictory. Giving cognizance to the tumor marker levels, the treatment was designed on the lines of NGGCT. Planning of radiotherapy including craniospinal irradiation (CSI) and boost to both lesions was once again a challenge, given the proximity of the lesions to vital organs at risk (OAR). Given the child’s age and location of lesions, the target volumes and doses of radiation were designed to optimize between the goals of achieving long?term local control and minimizing late?onset toxicities.Item Pediatric hepatocellular carcinoma in a 14-year-old boy: A rare case report(Wolters Kluwer – Medknow, 2024-09) Rajpoot, Jyoti; Jain, Manjula; Pujani, Mukta; Agarwal, Charu; Wadhwa, Ruchira; Sarohi, MonicaHepatocellular carcinoma (HCC) is much rarer in children and adolescents in comparison to adults with an incidence of 0.7/1,000,000 per year. Hepatitis B virus, a known carcinogen increases the chances of HCC at a young age. Very few case reports of HCC developing in HBV?positive male children have been published.We present a case of a 14?year?old Hepatitis B–positive boy who presented with abdominal distension and jaundice. Contrast enhanced computerized tomography (CECT) whole abdomen suggested a diagnosis of multinodular HCC with no evidence of metastasis on FDG PET?CECT. Histopathology with immunohistochemistry confirmed the diagnosis of moderately differentiated HCC.Clinical presentation of HCC in children is similar to adults. Viral hepatitis, metabolic disorders, and male gender increase the risk of HCC. In our case, boy never had any prior history of jaundice, abdominal pain/distension, or any other illness suggestive of liver dysfunction. When the boy was found to be HBV positive, his mother was also screened and turned out to be Hepatitis B virus positive. Histopathology along with a panel of immunohistochemical markers clinched the final diagnosis.Item Pleomorphic adenoma: Indeed, a versatile tumor(Wolters Kluwer – Medknow, 2024-09) Sharma, Rashim; Khera, Sudeep; Yadav, Taruna; Badkur, MayankPleomorphic adenoma is the most common and well?studied salivary gland neoplasm. It is a benign tumor most commonly occurring in the parotid gland although it can be seen in other major and minor salivary glands. There is a variety of metaplasia seen in Pleomorphic adenoma most commonly squamous metaplasia, others noted are osseous metaplasia, oncocytic metaplasia, sebaceous metaplasia, and adipocytic metaplasia. Also, at times tyrosine crystalloids are seen. This study discusses a few of the metaplasia and the presence of tyrosine crystals in pleomorphic adenoma. Indeed, this tumor proves true to its name.Item Computed tomography-guided radioactive iodine-125 seed implantation for liver malignancies in challenging locations(Wolters Kluwer – Medknow, 2024-08) Li, Lin; Tian, Shuhui; Han, Xujian; Tian, Jing; Zhang, CunjingAims: This study aimed to retrospectively assess the safety and efficacy of radioactive iodine?125 (I?125) seed implantation for liver malignancies in challenging locations. Materials and Methods: Between December 2015 and December 2021, 49 patients with 60 liver malignancies in challenging locations who underwent computed tomography (CT)?guided I?125 seed implantation were retrospectively analyzed. The primary endpoints included technical success rate and overall survival (OS), whereas the secondary endpoints included progression?free survival (PFS), disease control rate (DCR), objective response rate (ORR), and liver recurrence. Potential factors associated with liver recurrence were also evaluated. Results: The technical success rate was 100%. The median follow?up duration was 12 months (range, 2–68 months). The mean OS and PFS were 17.58 months (95% CI: 13.64–21.52 months) and 13.14 months (95% CI: 10.36–15.92 months), respectively. The 2?month, 6?month, and 1?year DCR and ORR were 97.96% and 93.88%, 93.75% and 77.08%, and 93.48% and 60.87%, respectively. The 6? and 12?month tumor recurrence rates were 20.41% and 28.26%, respectively. The Kaplan–Meier method was used to estimate the time of liver recurrence, with our results showing that patients with primary intrahepatic cholangiocarcinoma had an increased likelihood of having earlier liver recurrence. No major complications developed during follow?up. Conclusion: CT?guided radioactive I?125 implantation could be a safe and effective alternative with promising survival benefits and high local control rates for liver malignancies in challenging locations.Item Primary signet ring cell carcinoma of the breast: A case report and literature review(Wolters Kluwer – Medknow, 2024-09) Kasapo?lu, Elçin; Kandil, Berfin; Gökyer, Ali; Uzuno?lu, SernazPrimary signet ring cell carcinoma (SRCC) of the breast is a rare and aggressive type of breast cancer characterized by increased intracellular mucin production. It has a high risk of metastasis and poor prognosis compared to other breast cancer types. We report a 56?year?old woman with primary SRCC of the breast who first presented with retraction on her left breast. Radiological examination revealed a mass that causes the retraction. The patient underwent left modified radical mastectomy, and pathology results showed a 70% signet ring cell pattern. Chemotherapy consists of an adriamycin?cyclophosphamide regimen administered. in this case, we aim to review the literature on this topic and inform the physicians.Item Cardiac migration of an implanted hepatic fiducial marker used for stereotactic body radiation therapy - A case report(Wolters Kluwer – Medknow, 2024-09) Soliman, Youstina; Antony, Febin; Vivian, Mark; Venkatraman, Sankar; Nashed, MagedStereotactic body radiation therapy (SBRT) has been increasingly used to treat liver malignancies because large doses of radiation can be delivered precisely to the target with a rapid dose falloff. Real?time tracking of implanted fiducial markers (FMs), combined with respiratory gating, further improves the accuracy of treatment delivery and reduces the dose to critical structures. There have been reports of migration of the FMs after implantation for SBRT. Calypso beacons, which use the electromagnetic wave reflections for the image guidance, have recently been used for image?guided liver SBRT. In the literature, there are no reports on the migration of Calypso beacons to the heart after implantation in the liver. In this report, we detail the first case of such migration. Respiratory?gated SBRT guided by the Calypso system was planned for our patient, who developed liver metastases in segments 6 and 5/4B shortly after the completion of radical chemoradiotherapy for anal squamous cell carcinoma. One of the three Calypso beacons inserted in the liver under computed tomography (CT) guidance was found to have migrated to the right ventricle, as seen in CT simulation images. SBRT was delivered with respiratory gating using the remaining two beacons. A fluoroscopic imaging performed during treatment confirmed the migrated marker to the right ventricle. Patient denied any cardiac symptoms and SBRT were delivered uneventfully. Ten months later, the patient died of disease progression.Item Effect of radiation dose rates and cisplatin on cytogenetic damage in rats receiving head–neck radiotherapy(Wolters Kluwer – Medknow, 2024-09) Unal, Dilek; Kiraz, Aslihan; Aydogan, Serhat; Sarica, Zeynep Soyer; Celik, Harun; Akay, Ebru; Eroglu, Celalettin; Kaplan, BunyaminBackground: We aimed to investigate effect of radiotherapy (RT) applications with different dose rates on cytogenetic damages, which focused on micronucleus (MN) formation, and evaluate how this damage varies by cisplatin in rats receiving head–neck RT. Material and Methods: Thirty?six Sprague Dawley rats were divided into five groups. The first and second groups were irradiated at a dose rate of 300 monitor unit/minute (MU/min) and 600 MU/min, respectively. The third group was irradiated at a dose rate of 300 MU/min and given cisplatin. The fourth group was irradiated at a dose rate of 600 MU/min and given cisplatin. The fifth group received neither irradiation nor cisplatin (control group). One thousand polychromatic erythrocytes were scored, and MN frequency in polychromatic erythrocytes was determined for each rat. Results: There was a significant difference among five groups in terms of the number of MN (p: 0.001). The number of MN was significantly higher in the 600 MU/min + cisplatin group (fourth group) compared to the control group [9.5 (1.0–23.0) vs. 1.5 (1.0–2.0), respectively]. It was also significantly higher in 600 MU/min + cisplatin group (fourth group) compared to 300 MU/min group (first group) [9.5 (1.0–23.0) vs. 2.0 (1.0–3.0), respectively]. On the other hand, there was no significant difference among other groups. Conclusions: Our findings suggest that RT given at a higher dose rate causes more cytogenetic damage, and this damage is increased by concurrent administration of cisplatin.Item Drug-induced acute febrile neutrophilic dermatosis (Sweet syndrome): A case report presented at Delhi State Cancer Institute(Wolters Kluwer – Medknow, 2024-09) Shah, Afsana; Meedimale, Santhosh; Kumar, Dinesh; Sharma, Pooja; Shukla, PragyaSweet syndrome is a rare, etiologically unknown dermatosis that can be idiopathic or associated with certain clinical conditions. Among these conditions are infections, autoimmune diseases, inflammatory bowel diseases, vaccinations, the use of medications, and neoplasias. Hematological neoplasias, particularly acute myeloid leukemia, are the most commonly described; however, the condition may also be related to solid tumors, being those of the genitourinary tract the most associated with the syndrome. Drug?induced Sweet syndrome has also been reported; however, it is rarely seen. We report a case of 59 years old male patient with a diagnosis of carcinoma urinary bladder, who developed skin eruption after infusion of the first cycle of chemotherapy (gemcitabine and cisplatin) and resolved after treatment with steroids. The diagnosis of Sweet syndrome was confirmed only after skin biopsy, cultures and laboratory investigations. Malignancy as the cause of skin eruptions was eliminated by the fact that it occurred only after infusion of chemotherapy and the tumor was still there in the bladder, and skin eruptions did not occur after stopping steroids.Item Oxaliplatin-induced transient ischemic attack (TIA): A rare presentation(Wolters Kluwer – Medknow, 2024-09) Jagtap, Vikas K.; Synmon, Baiakmenlang; Chyrmang, Deiwakor; Kumar, SumitOxaliplatin is a common drug used in the management of colorectal malignancies. Rare neurological side effects including amaurosis fugax, urinary retention, stroke, cranial nerve palsy, dysarthria, and dysphagia have been reported in the literature. Usually, such incidences are reported immediately after 1st dose of oxaliplatin infusion. We report a rare transient ischemic attack (TIA))?like side effects after 2nd dose of oxaliplatin infusion.Item Idiopathic multicentric Castleman disease(Wolters Kluwer – Medknow, 2024-09) Chaudhari, Vipul; Thakkar, Simran Jatin; Padwal, Namita; Karnik, NiteenAn elderly man presented with fever and chills for six months, associated with loss of appetite and weight loss, bilateral edema, and non?tender inguinal lymphadenopathy. The left?sided testicle was bulky, firm, and non?tender. Investigations revealed anemia, leukopenia, elevated erythrocyte sedimentation rate, and hypergammaglobulinemia. Ultrasound of the abdomen revealed multiple enlarged necrotic lymph nodes in the periaortic, preaortic, precaval, and bilateral pelvic regions. Fine?needle aspiration cytology (FNAC) of the inguinal nodes showed no acid?fast bacilli (AFB). However, excision biopsy revealed lymphoid tissue with effacement of architecture by diffuse proliferation of mature plasma cells, suggestive of the plasma cell variant of multicentric Castleman disease. Due to suspicion of neoplastic testicular enlargement, the patient underwent bilateral orchidectomy, and histopathology showed hematocele with atrophy of the testis and secondary involvement of the testicular parenchyma by plasma cell variant of Castleman disease.