Abstract. Gynaecological malignancies contribute significantly to cancer burden and have a higher rate of mortality and morbidity. The aim of this retrospective study was to determine the pattern of gynaecological malignancies identified between January, 2000 and December, 2011, at the Centre for Nuclear Medicine and Radiotherapy (CENAR). At CENAR 5,072 female patients were registered with different malignancies, of which 632 cases were gynaecological malignancies. Ovarian cancer (47%) was the most common gynaecological malignancy, followed by cervical cancer (29%), uterine cancer (14%), vulvar and vaginal cancer (6%), and gestational trophoblastic neoplasm (4%). Of the ovarian cancer cases, 72.5% had epithelial while 26.5% had non-epithelial cancer. Squamous cell carcinoma was 75.9% in cervix and 87.8% in vulva and vagina while endometrial carcinoma (75.9%) was more frequent in uterus. For gestational trophoblastic neoplasm, 69.2% of patients had choriocarcinoma. Ovarian cancer was the most common type for the age range of 50-59 years. In the case of cervical and gestational trophoblastic neoplasm the majority of patients presented at the ages of 40-49 and 30-39 years while uterus, vulvar and vaginal tumor presented in the elderly (>60 years). Thus, ovarian cancer is the leading gynecological malignancy in Pakistan.
Ewing sarcomas/primitive neuroectodermal tumors (ES/PNET) of the kidney are rarely found high-grade malignant tumors, offering poor prognosis. Although established treatment guidelines for ES of kidney are scarce, a multi-modality treatment approached is typically implemented. Herein, we report a 14-year-old female patient with ES of right kidney. Post-nephrectomy disease recurrence was treated with chemotherapy (i.e., vincristine, doxorubicin and cyclophosphamide); marked reduction in tumor size (i.e., from 18.5 9 11.3 cm 2 to 3.7 9 2.2 cm 2 ; *96% reduction in size) as per computed tomography images was observed. We present our treatment experience and review from the available literature.
Astroblastoma is an uncommon glial tumor with predominant manifestation in the young age. Herein, we report a case of 18-year-old astroblastoma female patient who presented with history of two months headache. Magnetic resonance imaging (MRI) of the brain demonstrated well circumscribed, intra-axial abnormal signal intensity lesion (size=5×4 cm2) in the right parieto-occipital region of the brain. The patient underwent complete surgical resection of the gross tumor, as confirmed by an early post-surgical MRI (i.e., within 24 hours of surgery). Histopathological examination revealed neoplastic lesion exhibiting perivascular pseudo-rosettes with centrally hyalinized blood vessel and focal nuclear pleomorphism. Immunohistochemistry staining illustrated reactivity for glial fibrillary acidic protein and integrase interactor 1 (INI-1). These features rendered the diagnosis of astroblastoma. A comprehensive review of the current literature to summarize the clinicopathological and radiological characteristics, prognostic factors and current treatment strategies of astroblastomas is also presented. Our study would expand the pool of this uncommon tumor towards its better understanding and optimal treatment.
Background: Micropapillary carcinoma (MPC), a morphologically distinct subtype of invasive ductal carcinoma, of the male breast is an exceedingly uncommon disease. Case Report: Herein, we report a case of triple-positive MPC of the male breast with axillary lymph node involvement and no recurrence for over 2 years. Specifically, a 60-year-old male patient presented with a hard, elastic, and well-defined painless mass in the right breast. The patient underwent unilateral (right) modified radical mastectomy with axillary clearance. Histopathology revealed MPC grade 3 and metastasis in 16/16 lymph nodes. Hormone receptor analysis demonstrated strong positivity (total score 08) for estrogen/progesterone receptors and overexpression (score 3+) of human epidermal growth factor receptor 2. The patient received adjuvant chemotherapy (6 courses of CAF: cyclophosphamide, doxorubicin, and 5-fluorouracil), radiation, and tamoxifen. The patient has remained disease-free for over 2 years. Conclusion: This study demonstrates that triple-positive MPC of the male breast as a rare malignancy appears to respond promisingly to multimodality treatment.
Primary testicular diffuse large-B cell lymphoma (DLBCL) is an uncommon and aggressive disease with predominant manifestation in the older age. Herein, we report a case of 47-year-old male patient who presented with three months history of left testis swelling. The patient underwent unilateral (left) radical orchiectomy. Histopathological examination revealed extensive involvement and replacement of testicular parenchyma by a tumor composed of large discohesive sheets of cells with pleomorphic, hyperchromatic nuclei and prominent nucleoli. Immunohistochemical (IHC) staining showed reactivity for LCA & Pan B (CD20) and negativity for OCT 3/4, SALL4 and Inhibin. Moreover, Pan T (CD3) highlighted reactive T-cells. These features rendered the diagnosis of DLBCL of testis. The hybrid 2-[fluorine-18] fluoro-2deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) demonstrated two para-aortic FDG avid lymph nodes on the left side at the level of L2 vertebra. Presently, the patient has been planned for doxorubicin-based chemotherapy (i.e., cyclophosphamide, doxorubicin, vincristine and prednisone; CHOP) along with intrathecal Methroxate (MTX), which would presumably improve the prognosis. Our study would expand the pool of this uncommon tumor towards its better understanding.
Background: Skin cancer is a broad term that refers to a variety of different types of cancer. It is usually recognized as non-melanoma and melanoma skin cancer. In many parts of the world, the prevalence is high, with significant ecological and ethical variation. Objectives: Objective was to determine demographic and histological features of skin cancer in Southwest region of Pakistan. Methodology: This retrospective study was carried out on skin cancer 1169 cases of Centre for Nuclear Medicine and Radiotherapy (CENAR) in Quetta. The data from January 2000 to December 2009 (10Years) was retrieved from record. The aim was to determine the importance of skin cancer in this area, its gender wise distribution and its pathological types. Results: Record of total 9308 cancer patients was retrieved from patients presenting to CENAR Quetta. From 9308 case, 1169(12.5%) patients were of skin cancer which was second most prevalent category of cancer in this area. Prevalence was higher in males with 713(61%) cases as compared to females. Pathologically with 634(54%) cases, the most prevalent category was Squamous cell carcinoma (SCC). Conclusion: Skin cancer is wide-spread type of cancer in patients of south-west region of Pakistan. The findings of this study are not aligned with published data. The difference is because of high altitude of the study area, dry climate and long skin exposure particularly in low socio-economic field workers. Keywords: Skin cancer, gender, Melanoma skin cancer (MSC), Squamous cell carcinoma (SCC), Non-melanoma skin cancer (NMSC), Basal cell carcinoma (BCC),
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