http://www.ijmpo.org/currentissue.asp Table of Contents:Indian J Med Paediatr Oncol 2009 - 30(4) Indian Journal of Medical and Paediatric Oncology Medknow Publications0971-5851 Brijesh Arora Sripad D Banavali Editorial Indian Journal of Medical and Paediatric Oncology 2009 30(4):121-123doi:10.4103/0971-5851.65333 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65333 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=121;epage=123;aulast=Arora http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=121;epage=123;aulast=Arora304 121 123 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=121;epage=123;aulast=Arora Brijesh Arora, Sripad D Banavali

Indian Journal of Medical and Paediatric Oncology 2009 30(4):121-123

]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=121;epage=123;aulast=Arora Pragya Shukla Deepak Gupta Shyam Singh Bisht Mohan Chand Pant Madan Lal Bhatt Kirti Srivastava Mahendra Pal Singh Negi Original Article Indian Journal of Medical and Paediatric Oncology 2009 30(4):124-130doi:10.4103/0971-5851.65334 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65334 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=124;epage=130;aulast=Shukla http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=124;epage=130;aulast=Shukla304 124 130 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=124;epage=130;aulast=Shukla Pragya Shukla, Deepak Gupta, Shyam Singh Bisht, Mohan Chand Pant, Madan Lal Bhatt, Kirti Srivastava, Mahendra Pal Singh Negi

Indian Journal of Medical and Paediatric Oncology 2009 30(4):124-130

Introduction: Metastatic carcinoma in the lymph nodes of the neck from an unknown primary is relatively rare, accounting for about 3% of all head and neck cancers. Management of secondary neck of undetermined primary is controversial. Materials and Methods: The case records of all the patients treated in the Department of Radiotherapy, Chatrapati Shahuji Maharaj Medical University, from Oct 1999 to Sep 2004, were studied and the patients with secondary neck without a known primary tumor were analyzed in detail to elucidate the outcome of various treatment modalities in various stages of the disease. One hundred and forty patients were found to be eligible for this analysis. Initial treatment could be divided into two categories: concurrent chemoradiation (n=76) and radiotherapy alone (n=64). Results: The patients who had received radiotherapy alone (53.1%) had lesser complete response as compared to those who had received chemoradiotherapy (68.4%). The overall survival duration in patients of the radiotherapy treatment group ranged from 5 to 60 months, with an average (±SD) of 31.06 ± 21.01 months, while in the chemoradiotherapy treatment group it ranged from 6 to 60 months, with an average (±SD) of 39.42 ± 21.33 months. Both hematological and nonhematological toxicities, although higher in the chemoradiotherapy group, showed statistically insignificant differences. Conclusion: To the best of our knowledge, this is the only study evaluating the role of concurrent chemoradiation in cases of secondary neck with primary unknown. The improved response rates along with an increased survival (both disease free and overall) show the superiority of chemoradiotherapy in the management of such cases.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=124;epage=130;aulast=Shukla Shalinee Rao Sandhya Sundaram Raghavan Narasimhan Original Article Indian Journal of Medical and Paediatric Oncology 2009 30(4):131-135doi:10.4103/0971-5851.65335 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65335 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=131;epage=135;aulast=Rao http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=131;epage=135;aulast=Rao304 131 135 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=131;epage=135;aulast=Rao Shalinee Rao, Sandhya Sundaram, Raghavan Narasimhan

Indian Journal of Medical and Paediatric Oncology 2009 30(4):131-135

Background: The biological behavior of endometrial carcinoma differs in epidemiology, presentation, and prognosis, suggesting that there are two fundamentally different pathogenic types of disease: type I (estrogen related, endometrioid type) and type II (non-estrogen related, non-endometrioid type). Untreated hyperplasia can develop into an endometrioid type of adenocarcinoma, hence, it is important to recognize the former type. In contrast to cervical cancers, there are limited studies with respect to the biology of hyperplastic lesions documented from India. This was a 16-year retrospective study, carried out to determine the nature and outcome of proliferative lesions of the endometrium in a referral center from south India. Materials and Methods: A histopathological diagnosis of the endometrial hyperplasia, polyp, and carcinoma, on endometrial biopsy and hysterectomy specimens, over a 16 year period (1983 to 1999), were recorded in a computer and the case slides were reviewed. Using the computer software Foxpro, the patients who had come more than once for a subsequent or previous biopsy were identified. An attempt was made to look for progression, regression or a static nature of the lesion in the follow-up cases. Results: A total of 1778 cases were studied, and only 74 patients with endometrial hyperplasia and five cases of benign endometrial polyp had follow-up endometrial histopathology. Hyperplasia cases included 59 cases of simple hyperplasia, 10 cases of complex hyperplasia without atypia, and five cases with atypia. The predominant age for patients with all types of hyperplasias was 41 - 50 years. Progression to a higher grade was seen in 8.10%, regression to a lower grade was seen in 9.45%, lesions reverted to a normal pattern in 10.81% cases, and lesions persisted in 70.27% of the cases. A mixed pattern was seen in 54 cases, with predominant coexistent lesion being simple and complex hyperplasia without atypia. Conclusion: The fate of the hyperplastic lesion of the endometrium showed a varied pattern. Follow-up cases predominantly showed persistence of the lesion, possibly resulting from a fluctuating but higher level of estrogenic stimulus. Hence, it was not only the high levels of estrogen that influenced the biology, but its sustenance for a prolonged period.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=131;epage=135;aulast=Rao Pavan Malleshappa Manjurhusen Aghariya Chandralekha Tampi Bharat V Shah Case Report Indian Journal of Medical and Paediatric Oncology 2009 30(4):136-137doi:10.4103/0971-5851.65336 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65336 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=136;epage=137;aulast=Malleshappa http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=136;epage=137;aulast=Malleshappa304 136 137 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=136;epage=137;aulast=Malleshappa Pavan Malleshappa, Manjurhusen Aghariya, Chandralekha Tampi, Bharat V Shah

Indian Journal of Medical and Paediatric Oncology 2009 30(4):136-137

The overall incidence of malignancies in post renal transplant recipients is reported to be approximately 5 to 6%. Malignancies are significant complications after transplantation. Common malignancies include malignancies of the skin and post-transplant lymphoproliferative disorder (PTLD). Squamous cell carcinoma of the tongue is very rare. We present a case of squamous cell carcinoma of the tongue developing nine years after renal transplantation, in a 30-year-old man. He underwent left hemiglossectomy initially and then modified neck dissection. His graft function continues to remain stable.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=136;epage=137;aulast=Malleshappa Samir R Agarwal Indranil Bhattacharya Yoganand V Patil Anjali D Amrapurkar Case Report Indian Journal of Medical and Paediatric Oncology 2009 30(4):138-140doi:10.4103/0971-5851.65337 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65337 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=138;epage=140;aulast=Agarwal http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=138;epage=140;aulast=Agarwal304 138 140 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=138;epage=140;aulast=Agarwal Samir R Agarwal, Indranil Bhattacharya, Yoganand V Patil, Anjali D Amrapurkar

Indian Journal of Medical and Paediatric Oncology 2009 30(4):138-140

Metastatic melanoma to the gall bladder is extremely rare and is associated with a very poor prognosis. We report a case of choroidal melanoma metastatizing to the hepatobiliary system, with an unusual presentation. Our patient presenting with obstructive jaundice was misdiagnosed as having carcinoma of the gall-bladder, but the diagnosis of metastatic melanoma to the gallbladder was confirmed by ultrasonography guided fine needle aspiration cytology (USG-FNAC). On reviewing the past history, the patient had a history of enucleation for choroidal melanoma. Even though the liver 'is' a common site for metastasis of choroid melanoma, the patient presenting with a suspected gall bladder mass 'is' a rare presentation. Hence, gastrointestinal symptoms and a history of melanoma should be investigated for the presence of gastrointestinal or liver metastases, even if the original primary malignancy was diagnosed years before the patient's presentation.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=138;epage=140;aulast=Agarwal Rahul Gupta Sandesh V Parelkar Beejal Sanghvi Case Report Indian Journal of Medical and Paediatric Oncology 2009 30(4):141-143doi:10.4103/0971-5851.65338 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65338 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=141;epage=143;aulast=Gupta http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=141;epage=143;aulast=Gupta304 141 143 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=141;epage=143;aulast=Gupta Rahul Gupta, Sandesh V Parelkar, Beejal Sanghvi

Indian Journal of Medical and Paediatric Oncology 2009 30(4):141-143

Mesenchymal hamartoma of the liver is the second most common benign liver tumor in children, yet its biology and pathogenesis are poorly understood. Typically, it presents as a large benign multicystic liver mass in children younger than three years, amenable to complete resection. Most tumors gradually increase in size, some reaching enormous proportions, some can undergo incomplete spontaneous regression, and rarely, few have shown malignant transformation to undifferentiated (embryonal) sarcoma. Here, we report a 13 month-old child who presented with abdominal distension and respiratory distress. Ultrasonography, Computed Tomography (CT), and magnetic resonance imaging (MRI) of the abdomen were suggestive of a mesenchymal hamartoma of the liver. Right hepatectomy was performed. Postoperatively, the patient recovered well. An attempt was also made to understand the possible etiology of the tumor.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=141;epage=143;aulast=Gupta Pragya Shukla Deepak Gupta Shyam S Bisht MC Pant Case Report Indian Journal of Medical and Paediatric Oncology 2009 30(4):144-146doi:10.4103/0971-5851.65339 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65339 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=144;epage=146;aulast=Shukla http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=144;epage=146;aulast=Shukla304 144 146 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=144;epage=146;aulast=Shukla Pragya Shukla, Deepak Gupta, Shyam S Bisht, MC Pant

Indian Journal of Medical and Paediatric Oncology 2009 30(4):144-146

We report the case of ovarian carcinoma with skin and umbilical metastasis in a 30-year-old female. The computed tomography (CT) scan of the abdomen showed a right ovarian mass with anterior abdominal wall metastasis. The CT-guided fine needle aspiration cytology (FNAC) from the ovarian mass showed adenocarcinoma. FNAC from the umbilical and skin metastasis also showed adenocarcinoma. Because of the unresectability of the mass, the patient was put on taxol-based chemotherapy, which she took for two cycles, and then died of progressive disease after three months.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=144;epage=146;aulast=Shukla A De H Mathurkar S Baveja MV Manglani Case Report Indian Journal of Medical and Paediatric Oncology 2009 30(4):147-148doi:10.4103/0971-5851.65341 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65341 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=147;epage=148;aulast=De http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=147;epage=148;aulast=De304 147 148 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=147;epage=148;aulast=De A De, H Mathurkar, S Baveja, MV Manglani

Indian Journal of Medical and Paediatric Oncology 2009 30(4):147-148

A female child admitted to hospital, diagnosed with acute lymphatic leukemia - CALLA positive, developed loose motions. Her stool culture and blood culture grew Pseudomonas aeruginosa. Although the diarrhea subsided after five days, the stool culture repeatedly grew P. aeruginosa for more than one month, in spite of treatment. Even though diarrhea due to Pseudomonas is rare, it can yet be seen in immunocompromised patients and is also associated with neutropenic enterocolitis. Stool specimens of all leukemia patients on chemotherapy and suffering from diarrhea, should be sent routinely for culture, so as to find out the exact cause of the diarrhea. Proper reporting will enable the clinicians to start appropriate antibiotics, thereby, reducing the morbidity and mortality of the leukemia patients.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=147;epage=148;aulast=De Shankar L Jakhar Rohitashwa Dana DP Punia Case Report Indian Journal of Medical and Paediatric Oncology 2009 30(4):149-150doi:10.4103/0971-5851.65343 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65343 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=149;epage=150;aulast=Jakhar http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=149;epage=150;aulast=Jakhar304 149 150 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=149;epage=150;aulast=Jakhar Shankar L Jakhar, Rohitashwa Dana, DP Punia

Indian Journal of Medical and Paediatric Oncology 2009 30(4):149-150

Phalanx bone metastasis as the initial manifestation of lung cancer is a rare presentation. A 70-year-old man presented with swelling and pain in his right ring finger. He had no other complaints or abnormal findings on clinical examination. A right hand radiograph showed an osteolytic lesion in the first phalanx of the ring finger. Fine needle aspiration cytology of the swelling suggested a metastatic adenocarcinoma. A skeletal survey, hematological, biochemical, and other radiological tests were found to be normal, except for an opacity seen in the right lung midzone. A bronchoscopic biopsy revealed adenocarcinoma of the lung.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=149;epage=150;aulast=Jakhar Amitabh Ray Ayan Basu Jyotirup Goswami Kalyan Bhattacharya Case Report Indian Journal of Medical and Paediatric Oncology 2009 30(4):151-152doi:10.4103/0971-5851.65344 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65344 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=151;epage=152;aulast=Ray http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=151;epage=152;aulast=Ray304 151 152 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=151;epage=152;aulast=Ray Amitabh Ray, Ayan Basu, Jyotirup Goswami, Kalyan Bhattacharya

Indian Journal of Medical and Paediatric Oncology 2009 30(4):151-152

Mantle cell lymphoma (MCL) is a moderately aggressive variety of non-Hodgkins lymphoma. Extranodal presentation of MCL is well known, the intestine being a common site. The incidence of colorectal involvement is relatively rare. Moreover, the recurrence of the disease at laparotomy scar site is even more rare. We report an unusual case of incision line recurrence in a case of colonic MCL occuring three years after initial treatment.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=151;epage=152;aulast=Ray Uday A Phatak Case Report Indian Journal of Medical and Paediatric Oncology 2009 30(4):153-155doi:10.4103/0971-5851.65346 Indian Journal of Medical and Paediatric Oncology 10.4103/0971-5851.65346 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=153;epage=155;aulast=Phatak http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=153;epage=155;aulast=Phatak304 153 155 http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=153;epage=155;aulast=Phatak Uday A Phatak

Indian Journal of Medical and Paediatric Oncology 2009 30(4):153-155

Immune Reconstitution syndrome following antiretroviral therapy is common in HIV/AIDS patients due to boosting of immunity. A case is reported here wherein AIDS-related Non-Hodgkin's lymphoma patient received CHOP regimen and antiretroviral therapy. Patient developed tubercular lymphadenopathy paradoxically as a manifestation of IRIS.]]> http://www.ijmpo.org/article.asp?issn=0971-5851;year=2009;volume=30;issue=4;spage=153;epage=155;aulast=Phatak