Depth of invasion (DOI) and tumour thickness (TT) are known prognostic indicators in oral squamous cell carcinoma (OSCC), but varying definitions have been used by pathologists for reporting. The American Joint Committee on Cancer (AJCC) has proposed adoption of a uniform definition of DOI and incorporated this measurement in the revised TNM staging (8th edition); however, unambiguous DOI determination can be a challenge in clinical practice. We reviewed archived slides of 95 cases of T1/T2N0 OSCC and listed the challenges in accurate DOI measurement with pictographical documentation. The impacts of DOI and TT on disease-free survival (DFS) were also assessed. The mean DOI and TT was 5.89 mm and 7.32 mm respectively. Challenge in horizon estimation for DOI measurement was experienced in 75/95 cases (78.9%). The most common challenges were lack of adjacent uninvolved mucosa in sections or presence only on one side, rounded/ convoluted nature of the tumour surface for tongue and polypoidal tumours, and angulation of adjacent mucosa for alveolar or lip tumours. In cases with very thin epithelium, DOI was equal to TT. In spite of the challenges, Kaplan-Meier analysis showed DOI > 5 mm significantly predicted poorer DFS while TT did not. We recommend various guidelines to help improve consistency in measuring DOI and recording of TT in ambiguous cases for accurate staging of OSCC.
Screening of vitamin D deciency is specially recommended in pediatric age group who is more prone for its deciency
and consequent impaired bone mineralization. An Institution based, Observational, Cross-Sectional study with an
objective to nd out the prevalence of vitamin D deciency among children attending pediatric OPD of a tertiary health care facility of Eastern
India. A total of 98 study subjects were selected through systematic random sampling. Serum 25 (OH) D was classied as decient, insufcient,
sufcient, therapeutic, and potential toxicity if the serum concentration was <20ng/ml, 20-29ng/ml, 30-60ng/ml, 61-100ng/ml and >100ng/ml
respectively. Data was analyzed using The Statistical Package for Social Sciences for windows (SPSS, version 20.0). Chi-square test was used to
show association between categorical variables. All statistical tests was 2-tailed and a p-value of <0.05 was considered signicant. Prevalence of
vitamin D deciency and insufciency was found to be 56.1% and 24.5% respectively. Only 19.4% of study participants had normal serum
vitamin D level. Adolescent age, female gender and urban residence were found to be signicant risk factors for hypovitaminosis D. In
conclusion, there is very high prevalence of vitamin D deciency and insufciency. High prevalence especially among adolescent, girls and urban
children calls for an immediate attention of the nutritional policy makers to address this problem.
Primary mucinous adenocarcinoma (PMC) of skin is a rare adnexal epithelial neoplasm with eccrine differentiation. It is a rare tumour most commonly affecting the face and scalp region. We should be cautious before making its diagnoses as it closely mimics metastatic mucinous carcinoma from internal organs and a thorough search for any primary is warranted. Diagnosis can be only confirmed after excluding a primary mucinous carcinoma of other organs like breast, gastrointestinal tract, lung, salivary and lacrimal glands, urinary tract, prostate or paranasal sinuses metastatic to skin. Here, we report two cases of primary mucinous adenocarcinoma, one of axilla and other arising in periorbital region of face. Both the cases shows presence of PAS positive, diastase resistant mucin and are negative for CK-20 expression. Patients were undergone through an extensive search for any other neoplastic lesion by doing CT scan of thorax and abomen, upper GI tract enoscopy, colonoscopy, USG lower abdomen and pelvis but reveals nothing. Both the patients are doing well on one year follow up period.
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