Indian Journal of Cancer Education and Research

While it is the most common malignancy in women, breast cancer is rare in men and thus often ignored or overlooked, which leads to delayed diagnosis for the already fulminant condition. Bone is the most common location for metastasis from breast cancer, and there is a particular affinity for the spine. Despite the high incidence of spinal metastasis from breast cancer, only around 10 cases of breast cancer with spinal secondaries in male patients have been reported. Management of spinal metastases is palliative, with treatment aimed at restoring or preserving neurological function and relief of symptoms such as pain and incontinence. Here we report the case of a male patient with breast cancer and extensive metastasis to the axial skeleton and review the relevant literature.

Keywords: Breast Cancer; Male Breast Cancer; Spinal Metastases.

Metastases to skin from primary internal malignancies are rare with the incidence ranging from 0.7% to 10%. Cutaneous metastasis are frequently found in melanoma, breast cancer, or mucosal cancers of the head and neck. Subcutaneous metastases from squamous cell carcinoma of the esophagus are extremely rare (less than 1% cases reported). A 55 year old male a known case of carcinoma oesophagus presented with one subcutaneous nodule over the left ala of nose, another was found incidentally on anterior abdominal wall below umblicus. FNAC from both nodules revealed metastatic squamous cell carcinoma.

Keywords: Carcinoma Oesophagus; Subcutaneous Metastasis; Squamous Cell Carcinoma.

Sebaceous gland carcinoma is a rare malignancy which usually arises from periocular region. It accounts of 1–5.5% eyelid malignancies and represents third most common eyelid malignancy. It mostly occurs in elderly women and is characterized by high rate of local recurrence along with regional and distant metastases. A delay in diagnosis, often leads to inappropriate management with increased morbidity and mortality rates. This is a rare case report of sebaceous gland carcinoma of right upper eyelid that presented with metastasis to parotid lymph node.

Keywords: Sebaceous Gland Carcinoma; Parotid metastasis.

Recurrences after surgery or radiation for Carcinomas of uterine cervix are most commonly locoregional with the parametrium, lymph nodes and vagina as the most frequent sites of relapse. The occurrence of scar site metastases from carcinoma cervix is reported to be extremely rare ranging from 0.1 to 0.2%. We report here an unusual case of extensive scar site metastasisin patient with squamous cell carcinoma cervix operated earlier for simple hysterectomy and did not receive any adjuvant treatment. 60 year old female presented with 17x 10cm lower abdominal mass over the midline scar with multiple excavated ulcers on the surface. She was operated a year back for simple hysterectomy with bilateral salpingo-oophorectomy. Final histology came out as moderately differentiated squamous cell carcinoma of the cervix. Biopsy was taken from skin ulcer which was suggestive of squamous cell carcinoma. CECT scan was suggestive of a solid mass involving anterior abdominal wall and extensive areas of skin of around size 17 x15 x 12 cm and multiple omental metastasis. She was given taxane based chemotherapy after which she was also given palliative radiation to stop the bleeding ulcer but she succumbed to the disease. Scar site metastasis are an uncommon occurrence, with frequency of less than 5%. These have been frequently reported in cancers of colon, kidney, and bladder. The most common histopathology is adenocarcinoma and undifferentiated carcinoma, whereas squamous cell carcinoma is been rarely reported. The intent of treatment in advanced recurrent disease is palliation by surgery, chemotherapy, radiation therapy alone, and/or in combination. 

Keywords: Carcinoma Cervix; Hysterectomy; Adenocarcinoma; Uterine cervix

Recurrent cytogenetic abnormalities are noted throughout the course of multiple myeloma (MM) from the premalignant stage of monoclonal gammopathy of undetermined significance to end-stage disease. The prospective, observational study evaluated the frequency of structural and numerical chromosomal abnormalities in a cohort of 118 patients diagnosed with MM from south India using conventional cytogenetics. Chromosomal analysis was carried for both fine needle and bone marrow samples and the karyotypes were interpreted as per the International System for Human Cytogenetic Nomenclature. The  study identified 6 hyperdiploidy, 2  hypodiploidy and 3 pseudoploidy. The most common numerical abnormalities noted were gain of chromosomes 3, 5, 6 ,7, 11, 15, 16, 18, 19 and 21, and loss of 10, 12, 14, 17 and 22. The study validated the role of CC in conducting primary screening of MM, especially in the resource-poor settings and in remote areas with limited diagnostic facilities

Keywords: Chromosomes; Cytogenetics; Karyotype; Multiple Myeloma.

Aim: To design and study the physical and radiological properties of Heterogeneous Thorax Phantom (HTP).Materials and Methods: The Computed Tomography (CT) images of thorax were imported on treatment planning system and analyzed for measuring the density of chest wall tissue, lung and soft tissue behind the lung. The mean and standard deviation of these different densities were noted and analyzed. A HTP with similar density distribution was made using slabs of SP34 and pinewood. A plan was made on actual patient’s CT  scan and on  HTP by putting 6 MV photon beam of 10x10 cm2 field size and source to surface distance of 100 cms perpendicular to the chest wall using anisotropic analytical algorithm with grid size 0.25 cm. Depths for isodose were measured in both the mediums. The CT scan of HTP was taken at three different interface regions. The doses were planned and  measured at these three interface regions using ionization chamber. Measured and planned doses were compared and analyzed. Results: The mean density of the chest wall, lung and soft tissue were found to be 0.94, 0.28 and 0.98 gm/cc respectively on patient’s CT scan, while 0.99, 0.27 and 0.99 gm/cc respectively in HTP. Variation in planned dose and measured dose on HTP at 6 cm, 10 cm and 18 cm depths were found to be 0.47%, 0.81% and 2.4%. Conclusion: Phantom mimicking thorax site along with advanced third generation Monte Carlo based algorithms which are based on biological dose calculation should be used for more accurate dose calculation.

Keywords: Heterogeneous Phantom; Slab-Pinewood-Slab Phantom; Third Generation Algorithm, Monte Carlo, Across XB; Monaco.

Introduction: Results of treatment in carcinoma esophagus have not been very encouraging as it usually presents in an advanced stage. We treated these inoperable carcinoma esophagus patients with concurrent chemotherapy and radiotherapy and got early symptomatic relief and good long term survival. Material & Methods: 46 patients included in this study were treated with induction chemotherapy with methotrexate on day 1 and cisplatin on days 2 to 5 followed by radiotherapy from day 6 and further cisplatin was given on days 21, 28 and 35 concurrently with radiotherapy. Results: Symptomatic relief was seen during the second week and 69.56% patients had local control at 1 year. The 3-year and 5-year overall survival (OS) was 47.83% and 15.22% respectively, with a median survival period of 32 months. Conclusion: This regime of sequential chemotherapy followed by radiotherapy and concurrent chemotherapy has given better overall survival with acceptable toxicities.

Keywords: Survival; Esophagus; Chemo-radiotherapy; Long Term.