 Issue No. 26, Jan. 2018 |
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| Issue No. 26 - Jan 2018 | ||
| 6-10 | Cytomorphologic Spectrum of Hurthle Cell Lesions of Thyroid: A Study of 54 Cases | |
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K.R. Anila1, Nileena Nayak1, Preethi Sara George2, K.
Jayasree1 |
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| Abstract | ||
| Introduction:
Lesions of the thyroid gland composed of
Hurthle cells constitute a wide spectrum
of pathological entities ranging from
benign hyperplastic nodules with Hurthle
cell metaplasia at one end to
malignancies like Hurthle cell
carcinomas. The cytological distinction
of these entities is not only
diagnostically challenging but are also
critical since they influence treatment
decisions. Aim: To critically analyze the cytomorphology of cases of Hurthle cell lesions in FNACs and to characterize cytological features shown to be statistically significant in predicting Hurthle cell neoplasm (HCN). Methods: During the period from January 2014 to August 2015, 1667 cases of thyroid FNAs were done at our centre, of which 54cases,showed a predominance of hurthle cells, i.e. more than or equal to 50% hurthle cells (>/=50%).These cases were included in the study and were critically reviewed for 9 cytomorphologic features which included cellularity, architecture, and percentage of Hurthle cells, background colloid, chronic inflammation, nucleoli, intranuclear cytoplasmic inclusions (INCI), nuclear grooves and transgressing blood vessels (TBV). The results were evaluated by using univariate and stepwise logistic regression (SLR) analysis; statistical significance was achieved at P-value < 0.05. Results: Out of the 9 parameters studied, the cytological features shown to be statistically significant in predicting HCN and distinguishing them from benign hurthle cell lesions(BHCLs) were increased cellularity, non-macro follicular architecture, >90% Hurthle cells, absence of background colloid and absence of chronic inflammation. Keywords: Hurthle cells, hurthle cell neoplasm, cytology, statistical analysis |
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| 2 | 11-17 | Rosai-Dorfman Disease – Five Years Retrospective Analysis from Tertiary Cancer Center |
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K. Aradhana,
B. Thejaswini, Shamsundar, R. Nanda,
Usha Amritham, G.V. Giri |
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| Abstract | ||
| Aim: To study the
pattern of presentation and management
of nodal and extranodal primary RDD.
Methodology: From 2010 to 2015, eleven patients diagnosed with Rosai-Dorfman Disease (RDD) presented at our institute. Nine of them were analyzed as they received treatment at our center. We had five neck primaries, three intracranial and one cutaneous disease. Hematological, radiological, histopathological and immunohistochemistry evaluation along with the treatment data was collected and analyzed. Results: Nine cases treated at our institute had a median follow up of 41 months. Four of the five neck node primaries were treated with corticosteroids. Of the four, two had complete and two partial responses locally. Remaining one patient had partial response to surgery and corticosteroids. Three patients with CNS presentation treated with radiotherapy to a total dose of 20-40 Gy, had complete response locally. However, two patients had simultaneous neck nodes during presentation. Partial response was seen with corticosteroids alone in one and with radiation to the neck in the other patient, of which one succumbed to myocardial infarction within 3 months post treatment. Two of them received re-irradiation to the recurrent lesions with good results. Conclusion: Due to its rarity there is no particular guidelines regarding the management of patients with RDD. We conclude that low dose radiation either in combination with surgery or corticosteroids in nodal or extranodal lesions has shown a better local control. Keywords: RDD; Rosai-Dorfman Disease; SHML; Sinus histiocytosis; Lymphoproliferative disease; Radiotherapy; Corticosteroids |
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| 3 | 18-22 | Lung cancer epidemiology among the Bahraini population, 1998-2011 |
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Najat Mohamed
Abulfateh1 Randah R. Hamadeh2,
Majida Fikree1
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| Abstract | ||
| Background: Lung
cancer is the fourth most common cancer
in the Gulf Cooperation Council
countries among males and the third
among females. It is the commonest
cancer among Bahraini males accounting
for 16.9% of all cancers and the third
in Bahraini females contributing to 5.8
% of all female cancers. The aim of this
study was to describe the epidemiology
of lung cancer among the Bahraini
population during the period 1998-2011.
Methods: All Bahraini registered lung cancer cases in the national cancer registry from 1 January 1998 to 31 December 2011 were included in the study. Incidence rates were calculated using the CANREG software, in which the annual crude incidence rates, age specific incidence rates and the age standardized incidence rate (ASR) were computed. Results: Six hundred sixty-four lung cancer cases (72.4%, males and 27.6% females) were diagnosed during the study period. The annual average number of cases was 47.5 per year. The mean age at diagnosis during the study period was 68.7±11.7 years. The average annual ASR was 26.1/100,000 among males and 10.0/100,000 among females. There was a tendency for a decreased trend of the ASR during 1998-2011 in both sexes. Twenty-six percent of lung cancer cases were squamous cell carcinoma and 17.9% adenocarcinoma. The grades of 70.3% were unknown and 13.4% were poorly differentiated. The stage was unknown for 65.0% of the cases, while 18.5% had distant metastasis and 9.8% were localized. The majority (88.9 %) of the lung cancer cases were dead by the end of the study period with a five-year survival rate of 3.0%. Conclusion: A welcomed decline in the incidence of lung cancer has been noted over the past 14 years. However, more efforts should be put to reduce the proportion of lung cancer cases with unknown stage and grade. The incidence of histological types, which are strongly dependent on tobacco smoking, notably small cell, squamous cell and large cell carcinomas, accounted for over one third of lung cancer cases. Future research should be directed towards better understanding of the lung cancer risk factors and the effectiveness of tobacco control measures in in the country. Keywords: Lung cancer, epidemiology, trends, cancer registry, survival, incidence. |
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| 4 | 23-26 | Epidemiology of Colorectal Cancer in Iraq, 2002-2014 |
| Safauldeen
Abdulrahman Al Dahhan1, Faris
H. Al Lami2 1 Iraq Ministry of Health, Directorate of Public Health 2 Baghdad University, College of Medicine, Department of Community Medicine |
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| Abstract | ||
| Objectives: After
cardiovascular diseases, cancer is one
of the major causes of death in Iraq but
there is scarcity of data on cancer.
This study aimed to estimate the
incidence rate of colorectal cancer in
Iraq and its distribution and determine
its trend in Iraq from 2002 to 2011.
Methods: The necessary data for recording the incidence of colorectal cancer in Iraq were obtained from three main sources including the cancer registry for the period of 2002-2014. Data included information on gender, age, geographical distribution, site of tumors, and histology types. Results: A total of 7,246 cases of CRC were registered in the cancer registry for the period 2002-2011 and 706 cases in the National Cancer Hospital between 2012 and 2014. Male to female ratio varied from 1.17:1 to 1.28:1. About 40%-46% of cases were diagnosed in the age group of 40-59 years. The incidence rate increased from 2.75/105 pop in 2002 to 3.26/105 pop in 2011. Adenocarcinoma constituted 84.0% of all cases. Of the 706 registered cases during 2012-2014, 95% were diagnosed by histology of primary site. The degree of differentiation was moderate in 56% of cases. About 26% of cases were localized, 55.9% and 16% were with regional, and distant metastasis, respectively. Conclusion: Iraq has a low CRC incidence rate but with a steady increase overtime. It is crucial to implement preventive strategies to control CRC in Iraq and to establish public awareness program about CRC and the importance of screening. Keywords: colorectal cancer, epidemiology, trend, Iraq |
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| 5 | 27-32 | Profile of High Grade Gliomas – A Single Center Experience |
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Basharat Mujtaba Jan2,
Arif Hussain Sarmast1, Abdul
Rashid Bhat2, Altaf Rehman
Kirmani2 |
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| Abstract | ||
| Introduction: The
term high grade glioma (HGG), is usually
used to describe WHO grade III and IV
tumours. There has been a recent
increase in incidence of HGGs in the
Western world, particularly in the
elderly population. This probably
reflects the easy availability of vastly
improved diagnostic imaging. A five year
retroprospective study was planned to
study demography, clinical presentation,
imaging, surgical intervention,
histopathological examination of
specimens and postoperative outcome of
patients of high grade gliomas. Objectives: To determine the demographic, clinical, histopathogical and radiological profile of patients of High Grade Gliomas (HGG) and to ascertain post-operative mortality at 24 hours and 7 days Material & Methods: The present study of 226 cases from our institute for the last 5 years (retrospective 3 years and prospective 2 years) extending from August 2010 to July 2015 is based on study about demography, clinical presentation, imaging, surgical intervention, histopathological examination of specimens and postoperative outcome. The clinic-pathological vis-a-vis imaging was also studied. The analyzed data from the results and observations of this study were compared with the previous studies. Results: The study was retrospective as well as prospective. Total of 226 patients were registered. Out of these, 225 patients were operated (except one patient). The provisional diagnosis was based on the radio-imaging basis and the final diagnosis confirmed by histopathological examination. Majority of patients operated for HGG, irrespective of the procedure or extent of resection had good surgical outcome after the procedure. Conclusion: The overall survival is multifactorial in HGGs. The surgical intervention particularly in patients with features of raised ICP due to mass lesion provides symptomatic relief and improves quality of life in majority of patients and are discharged reasonably in better state of health. Keywords: high grade, glioma, brain, tumour, glioblastoma multiforme |
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| 6 | 33-36 | Assessment of Sunitinib Alternative Prescription Schedules in Metastatic Kidney Cancer: A Study of 10 Cases |
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Habib Diallo,
Hasnae Alaoui Mhamdi, Salma Elouarzazi,
Mohamed Fadli, Rhizlane Belbaraka
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| Abstract | ||
| Background: Managing
metastatic Renal Cell Carcinoma (mRCC)
has been revolutionized during the first
decade of the 21st century due to the
development of targeted therapies. The
sunitinib is an oral multi-targeted
receptor Tyrosine Kinase Inhibitor
(TKI). It became the first targeted
therapy as first-line treatment to
improve the survival of patients with
metastatic kidney cancer. This treatment
consists in the oral intake of 50 mg of
sunitinib per day in a 6 -week cycle
including 4 weeks of treatment intake
(the “on” week) followed by a 2-week
break (the off week). The strong impact
of the treatment dose reduction or
discontinuation and the associated
adverse effects encouraged the
investigators to enquire about other
sunitinib schedules: continuous regimen
at 37.5 mg of sunitinib, 2 weeks out of
3 at the dose of 50 mg. The aim of this
work is to assess the efficiency and the
tolerance of the other prescription
regimens of sunitinib. Methods: This is a transversal study conducted from March 2013 until November 2017 in the Oncology/ Hematology Center of the Med VI University Hospital Center in Marrakech. All patients under supervision and treatment for metastatic kidney cancer evaluated after 3, 6 and 9 months are part of our study. The parameters studies are epidemiological data, histological type, used protocols efficiency and tolerance. Results: A total of 10 patients under supervision for metastatic kidney cancer were gathered in the Oncology/Hematology Center of the Med VI University Hospital Center in Marrakech. At the end of the 9-month evaluation period, 10 patients (40%) had radiological and clinical stability, 1 patient had complete lesion response, 3 patients had radiological progression and 1 case of death was recorded. As regards toxicity, all different regimen used during the study were well tolerated by the majority of the patients. The toxicities mostly encountered were asthenia, hand-foot skin reactions, mucositis and grade II diarrhea for 4 patients (40%) and 1 case of HTA. In only one case of temporary cessation vomiting and grade II diarrhea were noted. Conclusion: The regimen 2/1 appears to be effective and demonstrates a better toxicity profile, treatment adherence, and dose intensity in relation to treatment, suggesting that the 2/1 regimen may become the future standard sunitinib treatment for patients with mRCC. Keywords: Renal cell carcinoma, Sunitinib, regimen, Efficacy, Toxicity. |
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| 7 | 37-42 | Human Papilloma Virus (HPV) in Sinonasal Papillomas and Squamous Cell Carcinomas: A PCR-based Study of 60 cases |
| Ambreen
Beigh1, Ruby Reshi1,
Sheikh Junaid2, Mehnaz Sultan
Khuroo1, Summyia Farook1
1 Department of Pathology, 2 Department of Surgery, Government Medical College, Srinagar, India |
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| Abstract | ||
| This study was
carried out to observe the association
of Human Papilloma Virus (HPV) with
papillomas and squamous cell carcinomas
of the sinonasal region. The present
study was a hospital-based study
conducted over a period of three years
from May, 2014 to May, 2017 in the
Department of Pathology, Government
Medical College, Srinagar. A total of
196 cases of non-neoplastic and
neoplastic lesions of nasal cavity and
paranasal sinuses were observed during
the study period. Out of total 196
cases, 102 were non-neoplastic and 94
were neoplastic. Of the 94 neoplastic
lesions, 58 were benign and 36 were
malignant. A total of 60 cases which
included 38(63.33%) inverted papillomas,
12(20%) exophytic papillomas and 10
(16.66%) squamous cell carcinomas were
included in the present study for HPV
association. We studied the association
of HPV with sinonasal papillomas and
squamous cell carcinomas by polymerase
chain reaction (PCR). HPV positivity was
seen in 5(13.16%) out of 38 cases of
inverted papillomas, whereas 4 out of
12(33.33%) exophytic papillomas tested
positive for HPV. Out of 10 squamous
cell carcinomas HPV positivity was seen
in 2(20%) cases. Low risk HPV types 6
and 11 showed an association with
sinonasal papillomas and oncogenic HPV
types 16 and 18 with squamous cell
carcinomas. Keywords: Sinonasal, inverted, exophytic, Human Papilloma Virus (HPV). |
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| 8 | 43-48 | Cancer Statistics in Giresun Province, Turkey: A 12-Years Retrospective Review |
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Ayşegül Çebi1,
Egemen Akgün2, Tuncer Öztürk3,
Esin Avcı4 |
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| Abstract | ||
| Aim: The aim of this
retrospective study was to analyze 6,613
diagnosed cancer cases in the Black Sea
Turkish province of Giresun over a
period of 12 years. Material and Method: Data of this retrospective crosssectional study was collected from 6,613 cancer patients at Prof. Dr. A. İlhan Özdemir Education and Research Hospital between 2005- 2016. MINITAB 15 package software was used for statistical analysis. Chi-Square test and differences between two ratios significance test were used to calculate the relationship between two nominal (categorical) variables. Results: Total 6,613 cancer patient’s (3,759 men, 56.8% and 2,854 women, 43.2%) average age is 66.27±17.17. The most frequent types of cancer found among men included prostate (24.4%), bronchus-lung (12.5%) and colorectal (11.15%) cancer; whilst among for women it was breast (26%), thyroid (14.9%) and skin (10.6%) cancer, respectively. Kidney, bronchus-lung, skin, larynx, breast, bladder and thyroid cancer types were determined to be statistically significant according to gender (p<0.05). Conclusion: We reviewed the diagnosed cancer cases in Giresun province from 2005 to 2016. For men, the order of the most frequent cancer types mentioned is consistent with the statistics of both the European Union (EU) as well as the United States of America (USA); whereas for women it was consistent with Turkey’s own national statistics. However, our findings state that thyroid cancer is the second most common cancer type among Turkish women, this is in contrast to most other parts of the world, the EU and USA. Key words: Cancer, statistics, Giresun |
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| 9 | 49-57 | Risk Factors of Cancer in the United Arab Emirates |
| Hira Abdul
Razzak, Alya Harbi, Wael Shelpai, Ahmad
Qawas Statistics and Research Centre, Ministry of Health and Prevention, Dubai, UAE |
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| Abstract | ||
| Cancer is recognized
to be a major healthcare problem
globally. Cancer is a disease that
mainly occurs when alterations in a
normal cell group within the body leads
to uncontrolled growth, mainly causing a
lump referred to as a tumor. The aim of
this study is to systematically review
and extract studies reporting the risk
factors of cancer in UAE between 2007
and 2016. A systematic literature search
was performed by using “PubMed, Scopus
databases, Science direct, and local
journals” and appropriate key terms to
retrieve studies carried out in United
Arab Emirates with regards to risk
factors of the cancer. 75 articles were
extracted in the beginning. After
screening for exclusion criteria and
retrieval of full texts, overall 16
articles were used in this study. Search
limits were restricted to studies in
English language, between 2007 and 2016,
and on UAE population (both citizens and
expatriates). This review yielded 16
studies about the cancer risk factors in
United Arab Emirates, including cross
sectional studies (n = 9),
population-based crosssectional
retrospective survey (n = 1),
retrospective cohort studies (n = 4) and
qualitative studies (n = 2). Tobacco
use, unhealthy diet, family history,
infection with HPV, physical activity,
and radiation exposure were among the
factors investigated. There was
insufficient evidence available on some
potentially essential risk factors such
as use of alcohol, aging, and being
overweight. This systematic review
signifies an increasing cancer
prevalence in the United Arab Emirates
and suggests that extra effort is needed
with a multi-sectorial approach in
future at both the national and
international level to effectively
tackle the burden of cancer. Keywords: Cancer, risk, cancer screening, prevalence, early detection, prevention, UAE. |
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| 10 | 58-60 | Lymphoid proliferation in Eyelid: A Primary Follicular Lymphoma Case |
| Deivy
Cruzado-Sánchez1,2, Walter
Andree Tellez3, Solon
Serpa-Frias1, Grisnery
Maquera1 1 Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru 2 Ophthalmology Center Macula D&T. Clinical Research Unit, Lima, Peru 3 Sociedad Científica de Estudiantes de Medicina Villarrealinos (SOCEMVI), Universidad Nacional Federico Villarreal, Lima, Peru |
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| Abstract | ||
| Ocular adnexal
lymphoma (OAL) constitutes 8% of all
extranodal lymphomas, being rare in the
eyelids (5-20%). The objective was to
report a case of eyelid follicular
lymphoma in a young adult woman. A
35-year-old female with swelling in left
lower eyelid with development for 2
months. The visual acuity was 20/20 in
both eyes, the tumor mass was 3 cm wide
and 1.5 cm long. The contrast-enhanced
computed tomography showed a soft-tissue
injury in the left lower eyelid but had
no signs of local spread according to
description. Grade 2 follicular lymphoma
was diagnosed by biopsy. Oncological
evaluation assessed positron emission
tomography scan and bone marrow
aspiration with negative results for
systemic spread of disease. Patient
started radiotherapy. This case
highlights that young patients may
present painless swelling lesions that
may be largely underdiagnosed and should
take into consideration some oncological
pathologies. Keywords: Eyelid neoplasms, Lymphoma, Follicular Lymphoma |
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| 11 | 61-63 | Transanal Minimally Invasive Surgery (TAMIS), First in Kuwait: A Case Report |
| Abdullah A.
AlHaddad1, Ali S. Mouzannar1,
Bader Marafi1, Ibtisam
Albader2, Mosa A. Khoursheed2,
Ali Sayed Ahmed Alsayed1
1 Mubarak Al Kabeer Hospital, Kuwait City, Kuwait, 2 Kuwait Medical School, Al Jabriah, Kuwait. |
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| Abstract | ||
| Transanal Minimally
Invasive Surgery (TAMIS) is a one of new
platform used to help and achieve better
outcome in using transanal approach for
the treatment of rectal neoplasm. High
definition camera and high tech
equipment are used to perform this kind
of surgery. The main benefit of using
this approach is to provide the best
outcome or the patient compared to the
traditional transanal approach. This
platform can be used for a variety of
cases, benign and malignant tumor and
for the benign condition. We report the
first TAMIS performed in the Kuwait and
probably in the Middle East with 2 years
of follow up. We had no complication and
patient returned home and to normal
activity in next day. More studies
needed to validate this technique. Keywords: TAMIS, Kuwait, Transanal, Minimally invasive, Rectal neoplasm |
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| 12 | 64-66 | Tumor Recurrence at Donor Site of Pectoralis Major Myocutaneous Flap with Tumor-free Primary Oral Carcinoma |
| Rakesh Kain,
Suvashis Dash Department of Burns, Plastic and Maxillofacial Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India |
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| Abstract | ||
| Pectoralis major
myocutaneous flap is an important option
for post onco reconstruction in head and
neck region. Among the several
complications mentioned in the
literature, tumor recurrence at the
donor site of flap is late and rare
complication. Tumor implantation at the
donor site of flap is a possible
explanation. The occurrence of this type
case is rare. We are reporting a case of
tumor recurrences of pectoralis major
myocutaneous flap donor site without
presence of index tumor or detectable
systemic disease. The recurrence was
operated in our case. Clinicians should
be aware of this condition for better
management of patients with similar
presentation. Keywords: Pectoralis major flap; Pectoralis major myocutaneous flap; Flap complication; tumor recurrence; Head and neck reconstruction. |
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| full article | ||
| 13 | 67-71 | Vaginal metastasis of renal clear-cell cancer |
| Rehailia-Blanchard
Amel1, Morel Adeline2,
Rancoule Chloé1, He MingYuan1,
Magné Nicolas1, Falkowski
Sabrina3 1 Dept. of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France 2 Dept. of Oncology, Curie Institute, Rene Huguenin Hospital, Saint Cloud, France 3 Department of Oncology, CHU Limoges |
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| Abstract | ||
| Background: Vaginal
metastases originating from renal cancer
remain a rare event, with less than 100
cases reported in the literature. The
spreading mechanism is still under
scrutiny. The tumoral bleeding often is
a symptom revealing vaginal metastases.
Case: The present work reports patient
case having vaginal metastasis of renal
clear-cell cancer. The vaginal
metastasis was treated by a 3-D
conformational radiotherapy. Our
experience is discussed with respect to
an updated literature review concerning
the medical management of vaginal
metastasis related to kidney cancer.
Conclusion: In our case, a 15 Gy
hypofractionatedradiotherapy is
efficient to control bleeding on the
vaginal metastases of the kidney cancer.
To add up a 15 Gy hypofractionated-radiotherapy
in 5 fractions is an option if bleeding
is still present. The tolerance of the
treatment is excellent and no side
effects have been described. Keywords: Vaginal metastases, Renal cell carcinoma, bleeding, radiotherapy |
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| full article | ||
| 14 | 72-74 | T cell Large Granular Lymphocytic Leukemia with Pulmonary Hypertension |
| Sidra Khalid1,
Hamed Daw2, Miriam Jacob3,
Megan Nakashima4
1 Internal Medicine, 2 Department of Hematology and Oncology, 3 Department of Cardiovascular Medicine, 4 Department of Clinical Pathology Fairview Hospital – Cleveland Clinic, Cleveland, USA |
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| Abstract | ||
| T cell large
granular lymphocytic leukemia is a
hematological disorder which is
characterized by the proliferation of CD
3+ cytotoxic T cells. We present a case
about a patient who was diagnosed with T
cell large granular lymphocytic leukemia
and then developed pulmonary
hypertension. He was treated for his
leukemia with methotrexate and
simultaneously treated for his pulmonary
hypertension with selexipag and
ambrisentan. As his leukemia improved,
we also noticed an improvement in his
pulmonary hypertension from a NYHA class
IV to class I. Hence, we believe there
is an etiopathological link between the
T cell large granular leukemia and
associated pulmonary hypertension. Keywords: T cell LGL leukemia, pulmonary hypertension, methotrexate. |
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| full article | ||
| 15 | 75-78 | Fatal Outcome of Recurrent Infantile Pelvic Desmoid Tumor Treated with Tamoxifene |
| Lamiae
Amaadour1, Zineb Benbrahim1,
Othmane Zouiten1, Nezar
Bourdi2, Youssef Lamrani
Alaoui2, Asmae El Mazti3,
Nawal Hammas3, Nawfel Mellas1
1 Department of Medical Oncology, 2 Department of Radiology, 3 Department of Pathology, Hassan II University Hospital FEZ, Morocco |
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| Abstract | ||
| Desmoid tumors are
rare benign neoplasms with an aggressive
local growth. In children,
intra-abdominal localization is less
frequent and few reports exist in the
literature about the management of DTs
in those special patients. In our
report, we describe a case of a 13-year
old patient with a bifocal
intra-abdominal DT, treated
unsuccessfully with tamoxifene, and we
discuss briefly the existing literature
data. Keywords: infantile desmoid tumor, Recurrence, Tamoxifene, intra-abdominal site. |
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