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.
Adenocarcinoma lung with upfront metastases to skeletal muscle is rarely encountered in clinical practice since skeletal muscles are highly resistant to dissemination from solid organs. Moreover, these muscle metastatic lesions generally present with pain and palpable mass to get detected clinically. However, silent skeletal muscle metastases without any symptoms or signs getting detected by functional imaging with whole body 18F-fluorodeoxyglucose positron emission/computed tomography (18FDG-PET/CT) scan have been scarcely described in literature, while we present such an interesting case in a 45-year-old female. She was diagnosed as a case of biopsy-proven metastatic adenocarcinoma lung after evaluation by 18FDG-PET/CT. Despite treatment with palliative chemoradiotherapy, her disease progressed, and she finally succumbed to her illness. This case is discussed to highlight an unusual scenario we encountered, the clinical course of the disease with its management and overall poor prognosis.
The river Ganges largest tributary is river Yamuna and it is the longest tributary in India serving millions of individuals. It is emerging from the glacier known as Yamunotri that has a height of 6,387m that travel through Uttarakhand to Allahabad. The water from river is abstracted as well as in stream used for irrigation, power generation, domestic water supply, industrial use, etc., because of which the after affects are many. In India, an alarming situation exists since quite a long time in river pollution. When river Yamuna enters Delhi, it meets the water quality guidelines with respect to Dissolved Oxygen (DO) and Biochemical Oxygen Demand (BOD) but during its exit the water quality deteriorated. The main reasons of deterioration of the river water are sewage discharge and industrial e uents and mis utilization of fresh water. The dilution capacity of the river also gets reduced due to signi cant water abstraction. The chief contributor of contamination is National Capital Territory (NCT) of Delhi followed by Agra and Mathura by either point or non-point sources.In this paper we investigated the ongoing trends in basic water quality guidelines of the River Yamuna which show huge deviation in Delhi segment. Due to the in uence of industrialization, urbanization and horticultural advances the Delhi segment gets severely contaminated. Yamuna Action Plan (YAP) was undertaken by the government for the restoration and preservation of the river Yamuna. The DO, BOD in the Delhi segment and eutrophicated segment investigation, the water quality parameter trends in the river Yamuna represent that regardless of the considerable number of endeavors the water quality isn't t for assigned best utilizations. The outcomes require inventive points of view in the advancement of a refreshed comprehensive preservation technique for the river Yamuna.
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