Asian Oncology Research Journal

Carpal Tunnel Syndrome Caused by Palmaris Profundus Sharing Common Sheath with Median Nerve

2023-03-14T13:00:00+00:00

Carpal tunnel syndrome is the most common entrapment neuropathy in adults, usually caused by thickening of the flexor retinaculum. Occasionally, compression of the median nerve at the wrist may be caused by the presence of an intracanalar tumor or anatomic variations. We report in this manuscript, the case of a carpal tunnel syndrome secondary to the presence of a palmaris profundus tendon included in a common sheath with the median nerve.

Malignant Parotid Salivary Gland Tumour: Mucoepidermoid Carcinoma- Treated with Surgical Excision and Adjuvant Therapy

2023-03-25T11:26:06+00:00

Salivary gland tumours are quite rare. The most common symptom of salivary gland tumours is an expanding, painless swelling. Most are benign and are found in the parotid glands. The biggest obstacle in handling them is the difficulty in differentiating benign from malignant tumours. However, the majority of cases will require surgical excision as a means of arriving at a certain diagnosis. The most common type of malignant tumour of the major salivary glands is mucoepidermoid carcinoma (MEC). Investigations like fine needle aspiration cytology and Magnetic Resonance imaging scans offer some important information in this regard. Surgery alone can effectively cure early-stage low-grade malignancies, but postoperative radiation is necessary for more advanced, high-grade tumours that have metastasized to nearby lymph nodes. We presented a case of mucoepidermoid parotid carcinoma (intermediate grade) in a twenty-two-year-old male patient who was treated with surgical excision and post-operative adjuvant chemo-radiotherapy.

Resection of an Abdominal Dermatofibrosarcoma with Reconstruction by Controlateral Pedicled Groin Flap: A Case Report

2023-04-05T08:23:41+00:00

Dermatofibrosarcoma protuberans (DFS) also known as giant cell fibrosarcoma is a rare malignant skin tumor, known for being locally aggressive but exceptionally metastatic. Tumor excision must include a wide lateral margin of 5cm to minimize recurrences. Reconstruction of the defect can be done by split-thickness skin graft, local or free flap depending on exposed elements and adjacent skin.

We report in this manuscript, the case of an abdominal dermatofibrosarcoma and the reconstruction of the consecutive soft tissue defect with a pedicled groin flap in the same operative time.

Primary Squamous Cell Carcinoma of the Stomach: A Rare Case study

2023-06-09T12:04:32+00:00

Primary squamous cell carcinoma is a rare malignant neoplasm of the stomach. Limited knowledge is available regarding its clinical presentation, imaging features, tumor markers, and management of the condition. A 47-year-old male patient presented with abdominal pain and distension of 15 days duration. On clinical examination, a firm mass was palpable in the abdomen, which moved with respiration. On imaging, there was a large extraluminal mass in the lesser omentum arising from the posterior wall of the body and antro-pyloric regions of the stomach with encasement of the celiac trunk and left gastric artery. The preliminary radiological diagnosis was a malignant gastrointestinal stromal tumor (GIST). In contrast, the immunohistochemical diagnosis was squamous cell carcinoma (immunopositive for P63 and cytokeratin). On PET-CT, the possibility of an unknown primary was ruled out. On review of the literature, the imaging findings of our case are similar to previous case reports on primary squamous cell carcinoma of the stomach with a few notable differences. It has a poor prognosis as the initial presentation is at an advanced stage, and no standard regimen of chemotherapeutic agents is available for successful treatment. Therefore, knowledge of clinical and radiological features of primary squamous cell carcinoma of the stomach is vital for early diagnosis and successful treatment.

Liposarcoma of Spermatic Cord: A Case Report on a Rare Recurent Paratesticular Tumor

2023-06-24T10:28:25+00:00

This is a case report of an elderly male patient who presented with recurrent scrotal liposarcoma on the contralateral side. A 76-year-old male patient presented with swelling in the left scrotum in 2018 which showed gradual increase in size for a period of 1 year. The patient underwent high inguinal orchidectomy. Histopathology report was given as Myxoid liposarcoma. Post-surgery the patient underwent chemotherapy for the same. The yearly follow-up visits were unremarkable. Liposarcoma of the cord should be differentiated from other para-testicular masses. It is rarely diagnosed preoperatively and is usually mistaken for inguinal hernia, hematocoele and hydrocoele.

A Case Report and Literature Review of Verrucous Carcinoma of the Anus

2023-08-14T05:46:01+00:00

Low-grade verrucous exophytic squamous cell carcinomas are uncommon. In 1948, Lauren identified a subtype of squamous cell carcinoma known as verrucous carcinoma (VC). Verrucous carcinoma develops rather slowly, and lymph node metastasis and distant metastases are uncommon. Local recurrences can be related to verrucous carcinoma. In most cases, verrucous carcinoma expands via direct extension. Here we present a case of 50 years male smoker who presented with perianal swelling. The patient underwent a biopsy and histopathology was suggestive of verrucous carcinoma with a focus on well-differentiated Squamous cell carcinoma. MRI pelvis done on 25.12.2021 was suggestive of large poorly marginated infiltrating mass lesion measuring 71x58x 42 mm centred in the skin and subcutaneous planes of left perianal region focally extending into left ischioanal fossa closely abutting the external sphincter at 3-4 0 clock position below the levator plane. No extension into inter sphincteric and supra levator area was seen. Enbloc excision of the perianal tumour with iliac and inguinal node dissection was done, the patient had recurrence after 1 year and repeat surgery was done, Post-surgery scans were suggestive of residual disease and locally advanced disease. The patient was subjected to chemotherapy and is now on follow-up.

Therapeutic for the Management of Pancreatic Head Adenocarcinoma about 40 Cases

2023-05-05T08:10:25+00:00

Pancreatic cancer accounts for the majority of malignant pancreatic lesions. Its incidence is increasing and its prognosis is poor.

Most patients are asymptomatic during the early course of disease, which often leads to delay in diagnosis.

Treatment options include surgery, chemotherapy, and palliative care.

The objective of this work is to describe and analyze the epidemiological and clinical profile and the therapeutic management of adenocarcinomas of the head of the pancreas as well as to report the experience of the digestive oncology and liver transplant department of the CHU IBN ROCHD, through a retrospective study spread over a period of 02 years, from January 2020 to December 2022.

This work is important for scientific community because pancreatic cancers had remained without symptoms for a long time, and they are diagnosed at an advanced stage.

Immunoexpression of Mutated BRAF V600E Protein in Papillary Thyroid Carcinoma

2023-01-14T12:29:13+00:00

Background and Objectives: In papillary thyroid cancer (PTC), BRAF V600E is the most prevalent genetic alteration, and in different populations, its frequency ranges from 29% to 83%. BRAF mutation is mostly detected by DNA-based molecular methods, which are labor-intensive and time-consuming. A method, immunohistochemistry (IHC), was recently introduced to detect BRAF-mutated proteins. This method enables a monoclonal BRAF V600E mutation-specific antibody that can distinguish BRAF V600E from wild-type protein in conventionally processed, formalin-fixed, paraffin-embedded tissue and the mutant protein that was directly visualized in tumour cells in a tissue context. This study aimed to determine the BRAF V600E-mutated protein's immunoexpression in papillary thyroid carcinoma.

Methodology: The study was a laboratory-based cross-sectional descriptive study. A total of 44 histologically proven paraffin-embedded tissue blocks of PTC were collected. Anti-BRAF V600E rabbit monoclonal primary antibody was used for immunohistochemistry on tissue sections, and the staining intensity was scored from 0 to 3 (+): 0, no cytoplasmic staining in tumour cells; 1: faint cytoplasmic staining in over 10% of tumour cells; 2+, moderate cytoplasmic staining in over 10% of tumour cells; 3+, strong cytoplasmic staining in over 10% of tumour cells. Tumour cells with a score of 1+, 2+, or 3+ were considered positive for mutated BRAF V600E immunoexpression, and those with a score of 0 were considered negative.

Results: Among 44 cases, 34 (77.3%) were positive, and 10 (22.7%) were negative for the mutated BRAF V600E protein by IHC staining. In terms of staining intensity, 4 (9.1%), 20 (45.5%), and 10 (22.7%) cases had IHC scores of 1+, 2+, and 3+, respectively. This study reported a high-frequency rate (77.3%) of mutated BRAF protein, similar to the frequency reported in other Asian countries. There was no association between mutated BRAF V600E protein status and either age or gender.

Conclusion: The most effective PTC diagnostic marker is BRAF V600E mutation. The IHC technique using BRAF V600E mutation-specific antibodies is relatively simple and faster and is therefore proposed as the most reliable first-line method for detecting BRAF V600E-mutated proteins.

Ultrastructure of Glial Brain Tumors and Pathomorphological Assessment of Changes after Cryodestruction

2023-04-11T13:06:17+00:00

Background: The role of cryosurgery in modern oncological practice is steadily growing now. Stereotactic cryodestruction of gliomas is one of minimally invasive techniques that helps to carry out more sparing surgical interventions in patients with glial tumors of deep, functionally significant structures. This study was aimed at studying the effects of cryoablation at the cellular level.

Materials and Methods: The authors analyzed the results of histological examination of the surgical material of 6 patients with supratentorial glial brain tumors of various degrees of malignancy. The sampling of the material for the study was carried out immediately before the introduction and after the extraction of the cryoprobe.

Results: A comparative electron microscopic examination in the areas of glial tumors after the cryodestruction showed manifestations of its gross destruction: ruptures of nervous tissue, fragmentation of the cytolemma and karyolemma, vacuoles of various sizes, including near the nucleus, various disorders of the chromatin structure, accumulation of gliofibrils in the absence of other organelles. The structure of myelin fibers in the glioma site after the cryotherapy was very diverse: there were myelin fibers with intense myelinopathy and axonopathy. The neuropile around the cells had a low electron density, or bundles of gliofibrils were found in it.

Conclusions: At EME of tumor tissue we found not only the specific, previously described signs of damage at the tissue level, but also the ultrastructural changes. The presented results show that the tumor cryodestruction not only results in direct destruction of tumor cells, but also triggers other mechanisms of glioma cell death. The above points to the need for prospective randomized controlled clinical studies with a large number of patients to determine the effectiveness of this promising method for the treatment of patients with glial brain tumors.

Correlation of Ultrasonography Features of Breast Masses with Hormone Receptor Status and Molecular Subtypes of Breast Cancer

2023-04-22T10:01:34+00:00

Objectives: The purpose of the study is to inquire the possibility of predicting tumour subtypes of breast cancer based on imaging features of breast lesions on ultrasonography.

Methodology: This cross-sectional study was conducted on 55 patients who were referred to the department of Radiodiagnosis of K.S.Hegde Medical Academy who were diagnosed or suspected to have breast cancer. USG features of breast lesions were characterised based on BIRADS lexicon. After histopathological confirmation and Immunohistochemistry (IHC) analysis, lesions were classified into molecular subtypes. Association of the USG features of lesions with molecular subtypes and hormone receptor status were assessed statistically.

Results: Majority of the tumours belonged to Luminal B (LB) subtype followed by Triple negative breast cancer (TNBC), human epidermal growth factor receptor 2/neu (Her 2 Neu) enriched and Luminal A (LA) subtypes in descending order. Majority of LA subtype showed non parallel orientation, posterior acoustic shadowing, calcifications and vascularity. Most of the Her 2 neu enriched subtype showed non-parallel orientation, lesion calcifications and none showed posterior acoustic features. Non parallel orientation and increased vascularity were also observed in TNBC lesions. Posterior acoustic enhancement was seen in only TNBC subtype lesion. Lesions showing posterior acoustic shadowing were associated more with Hormone receptor (HR) positive status.

Conclusion: Though most of the subtypes of malignant breast tumours showed similar features on USG , the combination of features would help in predicting the molecular subtype to some extent.

Detection of BRCA2 Receptor Gene Polymorphism in Sudanese Patients of Prostate Cancer in Khartoum State

2023-06-14T10:53:25+00:00

Back Ground: Prostate cancer (PCa) is a genetically complex disease with multiple predisposing factors affecting presentation, progression, and outcome. This was analytical case-control study conducted between January 2019 up to January 2021.

Objective: This study was aimed to investigate the effect of BRCA2 polymorphism in the etiology of prostate cancer among Sudanese patients.

Methods: The study population was selected as one hundred patients with prostate cancer as case group and thirty healthy individuals as control. A total of 5 ml EDTA anti-coagulated venous blood samples were obtained from prostate cancer patients that admitted for routine follow-up of chemotherapy treatment, for hormones and remain of blood samples were kept at liquid nitrogen until used for DNA extraction and genes polymorphisms at institute of tropical diseases of Khartoum.

Results: One hundred and thirty persons were included, 100 patients were men with prostate cancer as case group while thirty were healthy subjects as control with mean age of case was 67.41years. The result showed that (87%) of patients with wild type BRCA2 6174delT alteration and (13%) with mutant type. The mean result of testosterone level, Insulin G. F level, and PSA level in associated to BRCA2 6174delT was insignificant difference between patients with mutant and wild genotype (P. value= 0.91, 0.061, 0.449, respectively).

Conclusion: This study was concluded the most frequent prostate cancer patients (87%) with wild type BRCA2 6174delT and there was no significant correlation in testosterone level, Insulin G. F and PSA level when correlated to BRCA2 6174delT with different genotype.

Immunohistochemical Features of Prostatic Carcinoma in Southwest Nigeria: A Ten-Year Retrospective Study

2023-07-25T11:32:47+00:00

Background: The diagnosis of prostatic adenocarcinoma relies on a constellation of architectural and cytological features. However, some cases may pose some diagnostic challenges especially where there are only small foci of cancer where only a few atypical glands are present, especially in needle biopsies. Therefore, immunohistochemistry may be used to differentiate benign from malignant proliferations, primary prostatic lesions and secondary lesions from other sources.

Objectives: To determine the immunohistochemical profile of prostatic carcinoma seen at the Department of Morbid Anatomy and Histopathology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, using high molecular weight cytokeratin, alpha-methylacyl co-enzyme A racemase and Ki-67 markers.

Methods: This was a retrospective study involving all cases of diagnosed prostatic carcinoma in the Department of Morbid Anatomy and Histopathology of the Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria. The histologic slides were reviewed for the histological variant of prostatic carcinoma as well as the Gleason histologic grade of the tumour and the presence of high-grade prostatic intraepithelial neoplasia (HGPIN). Immunohistochemistry was done using high molecular weight Cytokeratin (HMWCK), a basal cell marker, and alpha-methyl acyl CoA racemase (AMACR), a marker of malignant prostatic cells. Ki-67 antibody was used to assess the proliferating index of the tumour.

Results: The majority of cases (72.8%) were seen between the ages of 61 and 80 years while the peak age of frequency was the 71-80-year age group. Prostatic carcinoma constituted 4.4% of all tumours and 18.7 % of malignant tumours. A total of 204 (54.8%) cases were well-differentiated tumours, 104 (27.9%) moderately differentiated, and 64 (17.2%) were poorly differentiated. The most common histologic type (73.7%) was acinar adenocarcinoma, while colloid carcinoma was the least common variant (0.2%). HGPIN was seen in 111 cases (29.9%). Most of the cases of prostatic carcinoma (78.8%) were negative for Ki-67. All well-differentiated tumours were negative for the marker.

Conclusion: Prostatic carcinoma is the commonest malignant tumour in males in this environment with a frequency that increases with age. Poorly differentiated tumours are more like to be associated with a younger age at presentation. HGPIN appears to be a true precursor lesion. Immunohistochemistry with HMWCK and AMACR should be reserved for equivocal cases only. The Ki-67 marker may help segregate tumours with poorer prognosis.

Outcome of Organ Sparing Trimodality Treatment of Muscle Invasive Bladder Cancer

2023-10-25T13:08:45+00:00

Background: Radical cystectomy leftovers the fundamental healing approach for muscle-invasive bladder cancer. However, there has been notable success in preserving the bladder through trimodality treatment, utilizing a mixture of the most significant Trans urethral resection of bladder tumor (TURBT) and chemo-radiation therapy.[1] The contemporary landscape of oncologic interventions is progressively inclined towards preserving organ function, optimizing functional outcomes, and upholding treatment effectiveness and quality of life (QoL). This Trimodality Therapy (TMT) encompasses Maximal TURBT, Radiation therapy, and Chemotherapy. Aim of the study was to observe the tumor response to treatment by concomitant Chemo-Radiation (TMT).

Methods: A quasi-experimental study of 47 patients with muscle-invasive bladder cancer who were ineligible for radical cystectomy was conducted from January 2012 to January 2019. Patients received induction chemotherapy with gemcitabine and cisplatin and radiotherapy with volumetric or intensity-modulated arc therapy. The median follow-up was 40 months, and the 5-year and recurrence-free survival rates were 59% and 50%, respectively.

Results: Trimodality therapy, combining surgery, radiation, and chemotherapy, demonstrated promising outcomes for muscle-invasive bladder cancer (MIBC) treatment. The 5-year Overall Survival (OS) rate reached 59%, surpassing the typical <50% rate. Disease-free survival (DFS) at 5 years was 50%. Completion rates varied among studies (NCI CTAE 21.30%, Our Study 12.70%, RTOG 6%), attributed to study criteria and resources. Despite differences, all contribute valuable MIBC treatment data. These findings endorse trimodality therapy as a standard MIBC treatment, offering optimal survival prospects.

Conclusion: Trimodality bladder preservation treatment presents a viable substitute for radical cystectomy for individuals who seek to maintain their bladder.

Radiological and Histopathological Diagnosis of Pulmonary Mass according to CT-Guided FNAC and Core Biopsy

2023-11-09T06:07:48+00:00

Background: Computed Tomography (CT) guided core biopsy and Fine-needle aspiration cytology (FNAC) are crucial diagnostic procedures for swiftly assessing pulmonary masses. They play a pivotal role in expediting the diagnosis process of such lesions.

Aims: The primary objectives of this study were to evaluate the effectiveness of CT-guided core biopsy and FNAC in diagnosing pulmonary mass lesions and to compare their results with histopathological findings.

Methods: We conducted a prospective analysis of 45 patients who underwent CT-guided core biopsy and FNAC between June 2022 and August 2023. Subsequently, patients clinically indicated for further assessment underwent tru-cut biopsy.

Results: Among the 45 cases studied, the majority (60%) fell within the age group of 50-65 years, followed by 28.9% and 11.1% in the age groups of 15-45 and 65+, respectively. The mean age was 52.13±13.91 years. Gender distribution showed that 67% of the respondents were male, while 33% were female. Regarding diagnostic procedures, 51.1% underwent core biopsy, 44.4% underwent FNAC, and only 4.4% opted for tru-cut biopsy. Radiological diagnoses indicated that 42.2% of the respondents had neoplastic masses, 24.4% exhibited metastatic lesions, 15.6% displayed consolidation, and 2.2% were diagnosed with tumors, tuberculosis, or chronic obstructive pulmonary disease (COPD). Histopathological results demonstrated that 33.3% of the respondents had carcinoma, 24.4% tested negative for malignant cells, 22.2% showed fibrosis, and 8.9%, 6.7%, and 4.4% were diagnosed with inflammatory lesions, pulmonary tuberculosis, and pleural effusion, respectively.

Conclusion: CT-guided core biopsy and FNAC emerged as straightforward, accessible, and dependable techniques for expeditiously establishing a tissue diagnosis of pulmonary masses while presenting minimal complications.

Unveiling the Crises of Breast Cancer in Young Nigerian Women: A Ten Year Retropsective Study in a North Central State

2023-11-20T06:33:05+00:00

Aims: To determine the proportion of breast cancers that occur in young women at the Jos University Teaching Hospital, Jos, Plateau State, Nigeria between the 1st of January 2013 to 31st December 2022. The age distribution and the percentage contribution of breast cancer among malignancies in young women will also be determined.

Study Design: This is a retrospective observational study.

Place and Duration of Study: Department of Anatomic Pathology and Forensic Medicine of the Jos University Teaching Hospital, Jos, Plateau State, Nigeria between the 1st of January 2013 to 31st December 2022.

Methodology: We extracted all 703 cases of female breast cancer diagnosed histologically and registered in the hospital-based cancer registry of Jos University Teaching Hospital, Jos, Plateau State, Nigeria. The age distribution and percentage of breast cancers diagnosed in women ≤40 years was determined. The total number of cancers diagnosed within the review period, the total number of cancers in women and the total number of cancers in women ≤40 years were also extracted and used to calculate the burden of breast cancer in relation to these groups.

Results: A total of 703 breast cancers were documented within the period of review, 211 (30.0%) of which occurred in women ≤40 years. The peak of breast cancer diagnosis occurred in the 5th decade. Female breast cancers accounted for 19.5% of all malignancies diagnosed within the period of review. They accounted for 32.5% of all cancers in women and 31.9% of cancers in women ≤40 years.

Conclusion: Female breast cancer was the commonest malignancy diagnosed during the period of our review. The proportion of cases diagnosed in young women in our study is significantly higher than observations in developed western nations.