Study of mass in ear was undertaken with the aim that clinical diagnosis was in most but not all cases consistent with the histo-pathological diagnosis. Therefore incisional or excisional biopsy with histo-pathological study is a must in all types of small masses in ear. A study of 50 patients, attending Ear, Nose and Throat department, was done and specimen collected from them and subjected to histopathological examination. These masses were further classified as inflammatory, benign and malignant lesions and the frequency of their occurrence in saurashtra region (Jamnagar, GUJARAT), their age and sex distribution were observed. Most common lesion was found to be inflammatory Polyps (20), followed by Cholesteatomas (12) and chronic non-specific inflammations (7), Abscess (1). In malignant lesions Squamous cell carcinoma (7) was the commonest followed by Embryonal rhabdomyosarcoma (1) and in benign lesion, Carcinoid tumor (1) and Nevus (1) were diagnosed on histo-pathological examination. Right side masses were more common than left side; males were more affected than females. Adolescents/children more affected than adults for benign lesions while reverse was true for malignant lesions.

Wilms’ tumor (WT) in adults is a rare neoplasm. Only a few reports are available in the literature. The tumor often masquerades as renal cell carcinoma (RCC). For accurate reporting, histopathological examination (HPE) plays a vital role in early diagnosis and prompt administration of multimodality treatment helps to improve the prognosis.We comprehensively analyzed five cases of adult WT presenting in the third to fifth decade with flank pain, hematuria, fever, and palpable lump. After complete clinical, biochemical, radiological, and HPE evaluation, tumor was staged and treatment was planned accordingly.Patients with low-stage WT were treated with open radical nephrectomy and chemotherapy. One of the patients diagnosed with inferior vena cava (IVC) thrombus apart from the above treatment also underwent IVC thrombectomy. Another young male presenting with distant metastasis (stage IV) and focal anaplasia on histology received preoperative chemotherapy and then planned for surgery. Unfortunately, the tumor being unresectable, second-line chemotherapy was given but he ultimately succumbed to death. All other patients are on regular follow-up and disease-free.Adult nephroblastoma is a rare clinical entity with hostile behavior. The presence of IVC thrombus is not a contraindication to surgery. Although the management strategy as per pediatric protocol by the inclusion of multimodality approach improves survival, still the overall prognosis in adults is dismal. There is a need for a standardized treatment protocol to encourage a homogenous approach for this rare disease and thereby improve survival.

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To evaluate the experience of RCC with IVC thrombus in terms of impact of clinical and pathological factors, level of thrombus and complications on outcome of the disease . Seventeen patients underwent radical nephrectomy and IVC tumour thrombectomy during 2012 to 2015 at our tertiary health care centre, clinico -pathological data from these patients were retrospectively analysed. Of the 17 patients (male: female: 3:1), the mean age was 57 years. The tumour thrombus extension was level I in 58%, level II in 29%, level III in 11%. In our series, the mean blood loss in levels I – III tumour thrombus were1863 mL, 3380 mL, 3250 ml respectively.Clavien dindo complications were -grade I in 1 case, grade II in 7 cases, grade III in 2 cases, grade IV in 3 cases. Pathological examination demonstrated that 13 out of 17 patients had clear cell carcinoma, five patients had higher grade(3, 4)and three had perinephric and IVC wall invasion. There was no perioperative hospital mortality. Two patients were lost to followup, one patient died due to extensive metastatic disease after 4 year, all other are under regular followup. Radical nephrectomy with IVC thrombectomy remains a challenging procedure. Multiple histopathological variables especially tumour stage and grade have a strong impact on the morbidity and mortality and also help in stratifying the subgroup in which adjuvant therapy is essential. With detailed perioperative planning and multidisciplinary efforts, surgical resection is the definitive treatment of choice for patients of RCC with IVC tumour thrombus.

Introduction: Gestational Trophoblastic Disease (GTD) is a term used for a group of pregnancyrelated tumours. These consist of various tumours and tumour like lesions characterized by proliferation of trophoblastic tissue. Amongst GTD, hydatidiform moles are the most common form. These lesions sometimes may develop into invasive moles, or, in rare cases, into choriocarcinoma. Risk factors of GTD include extreme of reproductive age, multiparity, smoking, alcohol consumption, lower socioeconomic class etc. Materials and Methods: The present study was descriptive, observational, analytical type done in Department of Pathology at M.P. Shah Medical College Jamnagar. All cases clinically suspected of GTD were included and its correlation with serum beta hCG was studied. The cases of GTD were classified according to WHO classification. Estimation of serum beta hCG level was done by using Indirect Sandwich Enzyme Linked Immunosorbent Assay (ELISA). Results: During study period of 1 year from October 2019 to September 2020, 150 sample received out of which 16 cases were diagnosed as GTD. Most of the cases were of hydatidiform moles, few cases of choriocarcinoma and Placental Site Trophoblastic Tumour (PSTT). The common clinical presentation was per vaginal bleeding and amenorrhea. In majority of cases beta hCG levels were between 50,000 to 100000 mIU/ml. The correlation between beta hCG level and GTD was done. Conclusion: Pregnant females clinically presenting with abnormal vaginal bleeding must be evaluated for GTD. Histopathological examination and serum beta hCG level are helpful for confirmatory diagnosis. Follow up beta hCG level is very useful indicator to detect these lesions and its recurrences.

Introduction: Ca19-9 is currently the single most useful tumor marker for diagnosis and prognosis of pancreatic cancer and cholangiocarcinoma. Aim: The aim is to elucidate the importance of tumor marker ca 19-9 as a diagnostic and prognostic tool in pancreatic carcinoma and cholangio-carcinoma. Material and Methods: The time period of the study was from september-2012 to september-2014. The patients were investigated pre-operatively and post operatively for ca 19-9 levels in their serum with the use of ELISA (enzyme linked immunosorbant assay) test. Results: Total 28 cases of pancreatic lesions were considered which included 24 cases of pancreatic ductal adenocarcinoma, It was observed that when preoperative serum CA 19-9 level was less than 37 u/ml median survival was 28 months. However when CA 19-9 level was more than 200 u/ml, median survival was 6 months. Out of 18 cases studied in gallbladder tumors, 15 cases were of cholangiocarcinoma. Patients with pre-therapy serum CA 19-9 level was between 37-200 u/ml median survival was 23.25 months. When CA 19-9 level was more than 200 u/ml, median survival was 10.25 months. Conclusion: Elevated level of ca 19-9 in pancreatic carcinoma and cholangiocarcinoma are associated with higher age group, male sex, higher histological grade, higher TNM staging and metastasis. Post operative ca 19-9 value has definitive prognostic value to detect any metastasis or recurrence in pancreatic carcinoma and cholangio-carcinoma. Therefore it can be concluded that ca 19-9 is an important tumor marker for pancreatic carcninoma and cholangio-carcinoma.