Renal cell carcinoma (RCC) accounts for 3% of all adult cancers and 85% of all kidney tumours. Incidence of RCC is lower in Asian region, particularly in India, probably due to lack of reporting. Most of the data about RCC are from Western countries; and data from India are scarce, especially regarding para-neoplastic syndromes. We sought to determine the epidemiology, clinicopathological profile and management of RCC in a tertiary care centre in Western India.This was a retrospective study that involved data analysis of records of RCC patients who presented to our institution from April 2016 to Feb-ruary 2020. Laboratory investigations, including tests for paraneoplastic syndrome (PNS), and relevant radiologic investigations were performed and treatment was offered according to the stage, patient factors and available modalities.A total 142 RCC patients were included in the study. The median age of presentation was 58 years. Most of the patients (67%) were symptom-atic, and 33% of the patients were asymptomatic, and the RCC was diagnosed incidentally. A large number of patients (56.3%) had PNS. The most common histopathologic type of RCC was clear cell carcinoma (68.8%), followed by papillary (20%) and chromophobe (8%) carcinoma. 40% of carcinomas with sarcomatoid differentiation were seen in patients under 50 years of age. Two cases of multicystic RCC were both seen in patients less than 50 years of age. 65.5% of the patients presented at Stage 1 and 2. Most surgeries (71.2%) were done in a minimally invasive manner.A significant number of patients were asymptomatic, in which RCC was detected incidentally. The age of presentation was earlier, yet the patients had a higher tumour stage. More than half of the patients had PNSs. Despite growing trend towards Western data, the significantly higher number of patients with PNSs and early age of presentation suggest inherent differences in tumour biology, possibly related to differences in genetic and environmental factors.
Background: Intestinal obstruction is one of the most common diseases in abdominal surgery. It can slowly lead to changes in intestinal structure and function, and in extreme cases it can be life-threatening. CT allows imaging of the abdominal contents outside the lumen, because of this advantage, the nature and site of the obstruction, especially extraluminal or intramural process, can be established.Methods: Prospective Hospital Based study. From January 2016 to November 2016 (11 months). 50 Patients presenting to Department of Surgery, whether in OPD or Emergency, with complaints suggestive of intestinal obstruction with in study duration eligible as per inclusion criteria will be included in the study.Results: In present study Majority (52.0%) of study population belonged to 41-60 years age group. The most common symptom was pain abdomen (94%). Majority (66%) patients showed multiple air fluid level on X-ray. In CT imaging, maximum 36% presented with dilated bowel loops. 86% were diagnosed as sub-acute intestinal obstruction, in USG. In present study, 60% patients were treated by surgery. Majority of patients (86.67%) CT findings matched with perop/ intraoperative findings. Accurate CT findings were helpful in guiding patient management. In our study, CT had the sensitivity of 86.67%, Specificity75%.Conclusions: Management decisions in intestinal obstruction remain notoriously difficult, relying on a combination of clinical and imaging factors to help stratify patients into conservative or surgical treatment.
Mucormycosis is a rare infection caused by fungi of the order Mucorales. The infection frequently involves the rhino-cerebral or respiratory system and involvement of the gastrointestinal (GI) tract and kidney are rare. It usually infects immunocompromised individuals due to various causes and an upsurge is hypothesized to be linked with irrational use of steroids during coronavirus disease 2019 (COVID-19) pandemic.We encountered a rare case of systemic mucormycosis that involved both renal as well as mesenteric vessels and led to ischemia of both vital organs. The patient developed massive bowel gangrene involving the duodenum, proximal jejunum, and left kidney due to angioinvasive mucormycosis.The diagnosis of GI mucormycosis may further increase during the current pandemic. The physicians, as well as surgeons, should be aware of this unwanted complication and keep a high index of suspicion for this rare disease.
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