Renal cell carcinoma is the most lethal malignancy of all the urologic malignancies. Outcome of those with metastatic disease is dismal with less than 50 surviving beyond 1 year. Several therapeutic strategies have been tried to improve the survival of these patients. Conventional chemotherapy regimens single or in combination failed to improve the response rates. Demonstration of immunogenicity in metastatic renal cell carcinoma gave birth to the concept of immunomodulation as potential treatment strategy in this setting. Though the response rates were better than chemotherapy but occurrence of higher adverse effects limits their use. Exploiting the immune response against tumour with the help of non myeloablative transplant, monoclonal antibody therapy and tumour vaccines have shown promising results in phase I / II trials. Newer chemotherapeutic agents like gemcitabine, capecitabine and novel agents like retinoids are being used in phase II trials. Radiotherapy does not have much role to play in metastatic setting except for palliation of painful bone lesions. This review focuses on the various treatment options available for metastatic renal cell carcinoma.

Henk M, Laszig R, Rube C, et al. Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomized, double blind placebo-controlled trial

Primary osteosarcoma arising from the vertebral column is very rare. We report here two such patients. It tends to occur in slightly older age group with median age of 38 years, than Osteosarcoma of the extremity. Patient usually presents with pain and neurological deficit. It could be secondary to Paget's disease or to irradiation received for a prior cancer. The differential diagnosis from benign tumour like osteoblastoma must be made and is discussed. The prognosis is generally poor.

The peak incidence of basal cell carcinoma (BCC) occurs in the seventh decade of life and is rare in children. When found in the pediatric age group, basal cell carcinoma is usually associated with a genetic defect, such as basal cell nevus syndrome, xeroderma pigmentosum, or nevus sebaceus. We report a case of BCC in a 10-year-old female child at an unusual site without any predisposing factors. To our knowledge this is the first reported case of basal cell carcinoma in a pediatric patient from the Indian subcontinent at an unusual site.

Non-Hodgkin's lymphoma is a common childhood malignant neoplasm. It occurs in the abdomen in approximately 35 percent of the cases. Nearly one half of these have a primary site in the GIT. We report a case of primary non-Hodgkin's lymphoma involving the sigmoid colon in a 10-year-old patient who presented with colonic Obstruction. Primary complete resection of the mass was done. Definitive diagnosis was of Non-Hodgkin's lymphoma.

A 6-year-old girl was admitted with complains of acne over face, hair over pubic area and deepening of voice for 4 months. She was investigated for virilizing adrenal tumour. Her hormonal assay confirmed functioning adrenal tumour. Exploration and excision of right adrenal tumour was done. Postoperative period was uneventful and she was discharged on 13th postoperative day. Histopathological report was adrenocortical carcinoma. Two months later she was admitted in shock and could not be revived. Pertinent Literature is reviewed.

Very few cases of carcinoma cervix presenting as bone marrow metastases have been reported in literature. This case report describes a patient of carcinoma cervix presenting as bone marrow metastases. The salient clinical, radiological and laboratory features have been discussed.