Mucosa-associated lymphoid tissue (MALT) tumors are a distinct subtype of non-Hodgkin’s lymphoma. Synchronous appearance of adenocarcinoma and colonic MALT lymphoma in the same patient is quite rare. In the present report, we describe a 68-year-old female who presented with a history of bleeding per rectum. She had no history of fever, loss of weight or drenching night sweats. Rectal examination revealed no abnormality. Colonoscopy showed a large ulceroproliferative mass arising from the hepatic flexure, biopsy of which came out to be adenocarcinoma of colon. A right hemicolectomy was performed and microscopic study revealed the tumor type to be synchronous adenocarcinoma with lymphoma. The final diagnosis of this patient turned out to be a synchronous manifestation of both colonic adenocarcinoma and colonic MALT lymphoma. Although the patient remains asymptomatic two years after surgery, the case highlights the therapeutic dilemma that prevails in the definitive management in such scenarios.

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Purpose The timely management of cancer surgery suffered due to COVID-19 and nationwide lockdown. Continuing cancer surgery was a challenge faced by all. We present our experience on cancer surgery in a cancer centre with high volume of patients and limited resources during early pandemic. Methods We retrospectively analysed our operation theatre database on surgery and anaesthesia from 1st April to 30th June 2020. Results A total of 457 surgeries were done-complex major, major, intermediate and minor surgeries constituted 43%, 25%, 12% and 20%, respectively. Median age of patient was 50 years, and 76% were below 60. The median ASA class was I (I-IV), and 97% were ASA I and II. The median Eastern Cooperative Oncology Group score was 0 (0-3), and 92% had score 0 and 1. Major cases done under regional anaesthesia were 30.7%. Median length of intensive care unit stay was 1 (1-6) days, and length of hospital stay was 7 (7-15) days. Clavien-Dindo Grade II complication in patients above 60 years was 16.4% and below 60 years was 17.6% (p = 0.76). 10% in ASA I compared to 26% of ASA II (p = 0.00) and 15.9% with ECOG 0 and 1 compared to 30.9% with ECOG 3 and 4 (p = 0.01) had grade II complication. Four (1%) patients had Grade C III CD complication. Covid testing was undertaken in 52% patients pre-operatively, and there was no positive case in post-operative period. Conclusions Adopting and implementing institutional policy catering to limited resource available at our centre, we facilitated cancer surgery.

Thyroglossal cyst is the most common congenital neck anomaly in children with equal sex incidence, but papillary carcinoma of the thyroglossal cyst in children is rare with only 10 cases reported so far. Even in adults, the incidence of malignancy in the thyroglossal cyst is only 1%. Most cases are diagnosed following surgery on histopathological examination; there is no consensus on the management owing to this rarity and indolent but unpredictable behavior of thyroid cancers. Here, we present one such rare case.

A 60-year-old female presented in the Department of Oncosurgery, A.H. Regional Cancer Centre, Cuttack with a lump in the left breast. The mass on examination was soft, irregular and nontender. It was in the inner and upper quadrant measuring 3 · 2 · 1.5 cm. Examination of the supraclavicular region and axillae did not reveal any palpable lymph nodes. Rest of the systemic examination was essentially normal. She was referred to the Department of Oncopathology for Aspiration Cytology with a clinical impression of Carcinoma of the breast. The material obtained by fine needle aspiration (FNA) was whitish and fluid like. Smears were stained with PapaFigure 2. Aspiration Cytology showing sheathed microfilariae admixed with inflammatory cells. The microfilariae are sheathed, coiled and the tail tips are free of granules representing the species Wuchereria bancrofti.Figure 1. Aspiration Cytology showing sheathed microfilariae admixed with inflammatory cells. The microfilariae are sheathed, coiled and the tail tips are free of granules representing the species Wuchereria bancrofti. 598 • parida et al.

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