Malignant peripheral nerve sheath tumor (MPNST) is a neurogenic tumor arising from peripheral nerves or nerve sheaths. MPNSTs are highly aggressive sarcomas mainly associated with neurofibromatosis type-1 (NF-1) with high rates of local recurrence and distant metastasis carrying a dismal prognosis. Lung is the most common metastatic site. Bone metastasis although documented in the literature is still very rare, while dissemination to brain without the involvement of lungs and that too in a non-NF-1 case is extremely unusual. A 48-year-old female was diagnosed with a case of non-NF-1 MPNST left thigh with bone metastases including sphenoid. Despite showing complete resolution of skeletal and primary lesions postpalliative chemoradiotherapy, she developed brain metastases and succumbed to her disease. This case is discussed to highlight an unusual scenario we encountered, the clinical course of the disease with its management, and overall poor prognosis. To the best of our knowledge, this may be the earliest case of MPNST with sphenoid metastases detected by 18-fluorodeoxyglucose positron-emission computed tomography scan and a sporadic case of brain metastases reported in the world literature.
Lung cancer is one of the most common and deadliest forms of cancer. It accounts for 13% of all new cancer cases and 19% of cancer-related deaths. In India, lung cancer constitutes 6.9% of all new cancer cases and 9.3% of all cancer cases. There has also been a dramatic rise worldwide in both the absolute and relative frequencies of lung cancer occurrence. In 1953 it became the most common cause of cancer mortality in men. By 1985, it became the leading cause of cancer deaths in women, causing almost twice as many deaths as breast cancer. The demographic profile of lung cancer has changed greatly over the years; however, methods for diagnosing, screening, and managing lung cancer patients have improved. This is due to our growing understanding of the biology of lung cancer. It is now possible to further define lung cancer types beyond small cell lung carcinoma and non-small cell lung carcinoma. Moreover, new histology-based therapeutic modalities have been developed, and more new lung cancer biomarkers have been uncovered. Therefore, more detailed histological characterization of lung cancer samples is warranted in order to determine the best course of treatment for specific patients. This review article describes how these new molecular technologies are shaping the way lung cancer can be treated in future.
Background:
Encountering more than one malignancy in a cancer patient is no longer uncommon; this increasing incidence is mostly attributable to the improvements in life expectancy, awareness, and diagnostic facilities. This article aims to highlight this institute’s experience in diagnosis and treatment of patients of multiple primary malignancies and a comprehensive review of literature.
Materials and Methods:
This is a descriptive study of retrospectively collected data of a single institution over 4 years from 2013 to 2016. Known cases of cancer who were diagnosed with a second primary malignancy were included in the study. Various details such as age, sex, site of disease, temporal relation of two cancers (synchronous or metachronous), family history, tobacco use, treatment given, and survival at 1 year were recorded, organized in a tabular form, analyzed, and described.
Results:
A total of 29 cases of dual malignancies comprising 0.74% of a total of 3879 patients of cancer were encountered. Seventy-two percent of the cases were metachronous and 5 years was the mean time interval between tumors. There was a female preponderance, and the average age was 56 years. Breast was the most common site of malignancy. At 1 year from diagnosis of second primary, 69% of the patients were alive and 27% were disease-free.
Conclusion:
Second primary in a patient of cancer is becoming increasingly common and the suspicion of the same should always be borne in mind during follow-up. Prognosis as well as intent of treatment depends on respective stages of the two malignancies.
Objectives:
Pleural effusion is one of the common presentations of several several diseases in clinical practice. The pathology behind a pleural effusion is often not clear on pleural fluid analysis. In developing countries like India, empirical antitubercular treatment is started assuming exudative pleural effusion to be tuberculosis. Over some time with more emphasis on evidence-based medicine, this is not a right approach. Thoracoscopic examination and biopsy visceral are a minimally invasive procedure which is underutilized in our practice. The study was conducted to evaluate the definitive etiological diagnosis of exudative pleural effusion and to analyze the diagnostic yield of thoracoscopic biopsy in the diagnosis of exudative pleural effusion.
Material and Methods:
The study was conducted in the Department of Medicine and Oncology, Command Hospital Airforce, Bengaluru, India. All adult patients with exudative pleural effusion (according to light’s criteria) reporting to the hospital from January 2019 to December 2020 were included and subjected for analysis.
Results:
Out of a total of 100 patients who were included in the study, there was male predominance with 78 males and 22 females. Thoracoscopic biopsy remained conclusive in 100% of cases. Malignancy was the most common etiology with 48% of cases while tuberculosis was seen in 38%, 12% had inflammation, and 2 (02%) had mucormycosis. TB PCR sensitivity and specificity of TB PCR were 42% and 100%, respectively. MTB culture showed sensitivity of 11%. MTB culture of biopsy showed sensitivity of 26%. The specificity in both the methods was 100%.
Conclusion:
Thoracoscopy is an ideal method for the diagnosis of pleural effusion with suspected exudative pathology. It gives an accurate diagnosis and helps differentiate between tuberculosis and malignancy which are the most common etiologies in India, thereby leading to early appropriate and specific treatment in such patients. Malignancy was the most common etiology in our study.
Cancer of the tongue and other parts of the oral cavity are a leading cause of death in the worldwide population. The common sites of metastasis from oral cavity cancers are lung and bone. Endobronchial metastasis of an extra-thoracic malignancy is a rare phenomenon and such metastases from a malignancy of the tongue are almost unheard of. We present a case of carcinoma oral cavity with subsite tongue that after radical therapy of local site had an unusual site of distant metastasis in the right main bronchus, along with metastases to the lung parenchyma and right third rib.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.