Sebaceous gland carcinoma of ocular adnexa is a highly malignant but relatively rare condition. It has an aggressive course with tendency for local invasion and systemic metastasis resulting in poor outcome and increased mortality. Here, we describe the clinical course of recurrent sebaceous gland carcinoma of the upper eyelid in a 55 year old female patient who presented with complaint of growth over right upper eyelid from 10 years.
Esophageal cancer is the seventh most common cancer constituting 3.2% of all cancer cases and sixth most common cause of mortality constituting 5.3% cases worldwide in 2018. Most common presenting symptom is dysphagia which is seen in 80–90% of patients. Most patients present in locally advanced stage and because of extensive local disease palliative radiotherapy plays a significant role. Aim and objectivesAim of the study was to compare two palliative radiotherapy schedules- 30 Gy in 10 fractions over 2- weeks versus 20 Gy in 5 fractions over 1-week in locally advanced carcinoma esophagus. Objectives were to compare above schedules based upon symptomatic relief and tolerability by the patient. Material and methodsThe study was a randomized control study done from July 2017 - December 2018 on 60 previously untreated, histo-pathologically proven patients of squamous cell carcinoma esophagus (locally advanced) reporting in the Department of Radiation oncology, Pandit B. D. Sharma PGIMS, Rohtak, where palliative radiotherapy was indicated as the treatment. Patients were divided into two groups of 30 patients each; Study group received- 30 Gy in 10 fractions over 2-weeks and Control group received 20 Gy in 5 fractions over 1- week. The symptomatic relief was assessed according to dysphagia score at 1- month after completion of radiation treatment. A reduction of at least 1 point in dysphagia score was depicted as improvement of dysphagia. Observations and resultDysphagia was the most common presenting symptom seen in all the patients followed by chest pain and weight loss. 80% patients in study group and 76.6% patients in control group showed improvement in dysphagia. 25% patients in study group and 43.4% in control group developed recurrent dysphagia. The mean duration of development of recurrent dysphagia in study group was 2.5 months and 5.6 months in control group. It was concluded that both the radiotherapy schedules were comparable in providing symptomatic relief; both radiotherapy schedules were tolerable by the patients.
Peripheral primitive neuroectodermal tumor of cranium or primary cranial Ewing’s sarcoma (ES) is an isolated phenomenon. So far, <100 cases are documented. The literature revealed good outcomes in favor of cranial ES due to less chances of distant metastasis; however, standardized treatment strategy is yet to developed. Here, we depicted the aggressive course of cranial ES by reporting the same in an 18-year-old young boy having right-sided scalp swelling of the 10-month duration. Despite providing combined modalities of treatment, the young boy departed his life with a short time of 12 months after diagnosis. Our case revealed the importance of early diagnosis in cranial ES. Strong emphasis should be given to employ different therapeutic approaches at the right time. Combination chemotherapy should be started as early possible and adjuvant radiotherapy is always recommended in subtotal resection. More case studies in future will also guide about independent prognostic markers of cranial ES.
Introduction. Esthesioneuroblastoma, also known as olfactory neuroblastoma, is a rare malignant neuroectodermal nasal tumor with distinctive clinical, histopathological, radiological, and molecular features. It arises from olfactory receptors in the nasal mucosa or the cribriform plate of the ethmoid bone. It is generally slow-growing; fast-growing tumors may lead to widespread metastasis. Here, we present an atypical case of aggressive esthesioneuroblastoma treated with a multimodality approach.Case description. A 28-year male, presented with a painful swelling over the right cheek lasting for 5 months. The patient underwent surgery, and histopathology of the surgical specimen revealed a small round blue cell tumor with widespread positivity for synaptophysin and CD 56. The histopathological appearance and immunohistochemical profile of the biopsy tissue confirmed esthesioneuroblastoma. Owing to subtotal resection, the patient received adjuvant radical radiotherapy to the local site and lymph nodes. Three months post-radiotherapy, a CECT scan showed a partial response, so the patient received intravenous chemotherapy. However, the patient had local disease progression; establishing the aggressivness of esthesioneuroblastoma in our patient. The patient is alive with residual stable disease after 2.5 years from the initial diagnosis and is follow up. Conclusion.Esthesioneuroblastomas are uncommon tumors and owing to their slow-growing nature, the patient may neglect them. There is a wide spectrum of clinical presentations and outcomes in such patients, and as the literature on esthesioneuroblastoma is scarce due to its rarity, this case report seeks to contribute to a better understanding of such uncommon malignancy in terms of its clinical presentation, behavior, and outcomes.
Introduction: Head and neck cancers include malignant neoplasms that develop in the oral cavity, nasal cavity, paranasal sinuses, pharynx, larynx and salivary glands. Out of the newly diagnosed patients of head and neck carcinoma in India, most of the patients present in locally advanced stage. Because of extensive local disease and associated co-morbidities and compromised KPS, palliative radiation therapy is preferred treatment for these patients. Material and methods: The study was conducted on 60 previously untreated, histo-pathologically proven patients of locally advanced head and neck cancer who were randomized in two equal groups by draw of lots. Study group received radiation dose of 30 Gy/ 10 fractions / 2 weeks followed by repeat dose of 30 Gy/ 10 fractions / 2 weeks (Total dose 60 Gy in 20 fractions delivered with a gap of 4 weeks). Control group received radiation dose of 20 Gy/ 5 fractions/ 5 days followed by repeat dose of 20 Gy/ 5 fractions/ 5 days followed by repeat dose of 20 Gy/ 5 fractions/ 5 days (Total dose 60 Gy in 3 sessions with a gap of 3 weeks each). Objectives were to compare efficacy of above schedules based on symptomatic relief and overall tumor response and to compare the toxicities of the above schedules. Results and Conclusion: To expedite the treatment time in tertiary care centres, control group (20 Gy / 5 fractions / 1 week; 3 weekly X 3) was better than the study group (30 Gy / 10 fractions / 2 weeks; 4 weekly X 2) as it had comparable local control and toxicity (acute mucosal reactions being slightly higher in the study group) with the added advantage of only 15 total fractions (machine days) in control group rather than 20 total fractions (machine days) in study group. This reduced the patient visits to the hospital by one week (i.e. 5 fractions) with comparable local control and toxicity.
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