Non urothelial bladder cancers frequently present a diagnostic and therapeutic challenge. The article presents a case series of 21 patients of non urothelial urinary bladder cancers presented in our institute over a period of three years and review of literature on this rare condition. Details of patients were reviewed from hospital records of surgical, medical, radiotherapy and pathology departments. Simple percentage and frequencies have been used to interpret the data. Total 21 patients were included in the study. 12 (57.2 %) were males and 9 (42.8 %) were females (M: F :: 4:3). Mean age of the patients was 51.3 years ranging from 22 to 65 years. Eleven (52.3 %) out of twenty one patients had hematuria as their presenting complaint. Out of 21, there were nine (42.8 %) adenocarcinoma, nine (42.8 %) were SCC and one (4.76 %) each of carcinosarcoma, neuroendocrine tumor and sarcoma. Fourteen (66.6 %) patients out of 21 were referred for upfront surgery. Out of remaining seven (33.33 %) patients from the non surgical group three were referred for definitive concurrent chemoradiation, two for definitive radiotherapy. One patient of adenocarcinoma (non urachal) was referred for palliative chemotherapy. Remaining one patient of neuroendocrine tumor who was referred for neoadjuvant chemotherapy died before any definitive treatment could be considered. This study highlights the role of surgery and status of adjuvant therapies in the management of non urothelial bladder cancers.
The purpose of this study is to investigate the outcomes of emergency external carotid artery ligation in head and neck cancer patients. It is a retrospective observational study of 11 patients with oral cavity and oropharynx cancers who underwent external carotid ligation as an emergency procedure. Prior tracheostomy was done in all the patients as part of the procedure. Parameters studied were the efficacy and safety of the procedure in the form of control of haemorrhage, any postoperative neurological deficit, morbidity and mortality. The study evaluates the efficacy of the intervention purely as an emergency procedure, and oncological outcomes have not been reported. Analysis was done using simple frequencies and proportions. The oropharynx is the most common site of tumour bleeding in head and neck malignancies. Bleeding following external carotid ligation stopped in all the patients immediately without any postoperative mortality or morbidity. No patient had any neurologic deficits postoperatively. There was one case of rebleeding. Emergency external carotid ligation in tumours of the oral cavity and oropharynx is a life-saving and simple procedure with limited morbidity. Prior tracheostomy is recommended in all the patients.
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