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Vasudevan B, Vendhan S, Sunita BS, Neema S. Phaeohyphomycosis Occurring at the Sacrococcygeal Region: An Unusual Presentation Diagnosed by Bedside Tests. Indian J Dermatol 2022; 67:626. [PMID: 36865861 PMCID: PMC9971749 DOI: 10.4103/ijd.ijd_161_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Affiliation(s)
- Biju Vasudevan
- Department of Dermatology, AFMC, Pune, Maharashtra, India
| | | | - B S Sunita
- Department of Pathology, AFMC, Pune, Maharashtra, India E-mail:
| | - Shekhar Neema
- Department of Dermatology, AFMC, Pune, Maharashtra, India
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Nandagawe D, Sunita BS. Endometrial hyperplasia with secretory changes. Med J DY Patil Vidyapeeth 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_252_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pandya T, Suhag V, Ranjan S, Sunita BS, Pandya S. Toxicity Profile of Double-agent Adjuvant Chemotherapy after Concurrent Chemoradiation and Brachytherapy in Locally Advanced Cervical Cancer: Comparison with Standard Chemoradiation Protocol. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_171_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Introduction: Carcinoma cervix is the most common gynecological malignancy in India and a major cause of cancer mortality and morbidity in the females despite Concurrent chemoradiotherapy (CCRT). Attempts are on to improved overall survival by addition of adjuvant chemotherapy (ACT) to CCRT. Aim: The aim of this study is to establish toxicity profile of double-agent ACT after CCRT and ICRT in locally advanced cervical cancer (LACC) and to compare it with standard chemoradiation protocol. Materials and Methods: Patients were randomized into two arms: in conventional arm (Arm 1, n = 23), patients received a standard protocol of weekly injection cisplatin 40 mg/m2 concurrently with pelvic external beam radiotherapy (5040cGy/28 fractions) followed by ICRT (03 fractions of 7 Gy each). In interventional arm (Arm 2, n = 24), patients received CCRT/ICRT protocol; and were further offered ACT with three cycles of consolidation chemotherapy using injection paclitaxel and injection carboplatin every 3 weeks after CCRT and ICRT. Results: The incidence of anemia was 14/23 (50% Grade 1) in Arm 1 and 12/24 in Arm 2 (17% Grade 1, rest higher grade). In Arm 2, 37% of patients had ≥Grade 2 neuropathy and 16% of patients had Grade 1 alopecia, whereas nil incidence was reported in Arm 1 (P = 0.005 and 0.04, respectively). Grade 3 neutropenia was observed in 4/23 (17%) patients of Arm 1 and 8/24 patients (33%) of Arm 2. None of the patients in Arm 1 required indoor supportive care while 4/24 patients (17%) were managed as an indoor patient. Among late toxicities, in Arm 2, the incidence of Grade 2 and Grade 3 anemia was 42%, whereas in Arm 1, its incidence was 22%. In Arm 1, no patient exhibited features of neuropathy, whereas, in Arm 2, 12/24 (50%) of the patients had neuropathy (P value for these two late events was <0.05 statistically significant). No therapy-induced mortality was noted. Conclusion: Exhibition of ACT with injection Paclitaxel and injection carboplatin in locally advanced carcinoma cervix is a technically viable option with manageable toxicity.
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Affiliation(s)
- Tejas Pandya
- Departments of Radiotherapy, ECHS Polyclinic, Base Hospital, New Delhi, India
| | - Virender Suhag
- Departments of Radiotherapy, ECHS Polyclinic, Base Hospital, New Delhi, India
| | - Subhash Ranjan
- Departments of Radiotherapy, ECHS Polyclinic, Base Hospital, New Delhi, India
| | - BS Sunita
- Departments of Pathology, Army Hospital (R and R), ECHS Polyclinic, Base Hospital, New Delhi, India
| | - Sujata Pandya
- Departments of Medical Officer Gynaecology, ECHS Polyclinic, Base Hospital, New Delhi, India
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Sivasankari M, Sinha P, Sunita BS, Awasthi S. A Case of Histoid Leprosy Presenting as Immune Reconstitution Inflammatory Syndrome (IRIS) in a Patient of Human Immunodeficiency Virus (HIV) Infection on Highly Active Retroviral Therapy (HAART). Indian Dermatol Online J 2021; 12:441-443. [PMID: 34211913 PMCID: PMC8202485 DOI: 10.4103/idoj.idoj_417_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/26/2020] [Accepted: 09/20/2020] [Indexed: 12/04/2022] Open
Affiliation(s)
- M Sivasankari
- Department of Dermatology, Military Hospital Jodhpur, Jodhpur, Rajasthan, India
| | - Preema Sinha
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
| | - B S Sunita
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Shivali Awasthi
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
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Abstract
Context Burkitt's lymphoma (BL) is one of the fastest growing malignancies. It is the most common subtype of Non-Hodgkin's lymphoma in childhood. It has three major subtypes - endemic, sporadic, and immunodeficiency-associated types. Aims This study aims to study the clinicomorphologic features of this disease entity and to find optimal imaging technique for such cases. Setting and Design A retrospective observational study in a tertiary care center of academic and research potential. Subjects and Methods We are presenting three unusual cases of sporadic type of BL who presented initially as localized right iliac fossa mass mimicking as acute appendicitis. Initially, localized presentation progressed to diffuse abdominal mass lesions causing intestinal obstruction. Results These cases had emphasized the importance of accurate diagnosis by the ultrasonography (USG) or computed tomography (CT) scan for early diagnosis so as to manage such cases simply by early appropriate medical treatment. Conclusion In this article, we will discuss the clinical and imaging features of BL with the role of USG, CT scan and positron emission tomography/CT in the abdominopelvic imaging of pediatric patients.
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Affiliation(s)
- Sunita Dashottar
- Department of Radio-Diagnosis, Military Hospital (CTC), Pune, Maharashtra, India
| | - B S Sunita
- Department of Pathology, Army Hospital R&R, New Delhi, India
| | - R K Singh
- Department of Anaesthesia, Pacific Medical College, Udaipur, Rajasthan, India
| | - Vandana Rana
- Department of Pathology, Command Hospital (SC), Pune, Maharashtra, India
| | - Virender Suhag
- Department of Radiation Oncology, Army Hospital R&R, New Delhi, India
| | - A K Singh
- Department of Radio-Diagnosis, Army Hospital R&R, New Delhi, India
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Suhag V, Sunita BS, Vats P, Chakravarty N, Pandya T, Lohia N. Tolerance of Chemoradiation in Advanced Head and Neck Cancers: Comparison Between Inpatients and Outpatients. Indian J Otolaryngol Head Neck Surg 2019; 71:192-198. [PMID: 31741959 DOI: 10.1007/s12070-017-1210-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 09/21/2017] [Indexed: 11/26/2022] Open
Abstract
Concurrent chemoradiation (CCRT) is the mainstay of treatment for majority of locally advanced head and neck carcinomas (LAHNC). Addition of chemotherapy to radiotherapy increases the probability of local control and improved disease-free survival but at the cost of acute and delayed toxicities. A retrospective observational study. To compare the tolerance of CCRT and its toxicity profile amongst two groups, first arm (Arm A) being outdoor patients and the second group (Arm B) was hospitalized patients of LAHNC in an oncology centre of a tertiary care hospital. A total of 100 patients were enrolled, 50 in each arm. Overall, the most common site was oropharynx, followed by larynx and hypopharynx. 38 patients in Arm A received full 6 cycles of weekly chemotherapy with Inj Cisplatin infusion. 39 of the hospitalized patients completed 6 cycles of weekly Cisplatin, 04 patients also received 3 weekly Cisplatin. Average duration of treatment was 49.18 days in arm A and 50.92 days in arm B. Incidence of Grade II onwards dysphagia was 48 and 45 (96 and 90%) in Arm A and Arm B respectively; Chi Square value-0.6 (Yate's corrected); P value-0.43. Grade III oral mucositis was seen in 14% patients in Arm A and 34% patients in Arm B. 3 patients (6%) in Arm A and 14 patients (28%) in Arm B has Grade II and III hematological toxicities and nephrological toxicities. Aspiration pneumonia was seen in 2 patients (4%) in Arm A and in 4 patients (8%) in Arm B, Chi Square value-0.2 (Yate's corrected) P value-0.67. The incidence of febrile neutropenia was 3 and 10 in Arms A and B (6 and 20%) respectively. The tolerance of CCRT in hospitalized patients is marginally better, with relatively few associated complications as compared to outdoor setting. Every institute should promulgate its own guidelines regarding hospitalization of such patients.
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Affiliation(s)
- Virender Suhag
- 1Department of Radiation Oncology, Army Hospital (R&R), Delhi Cantt, Delhi, 110010 India
| | - B S Sunita
- 2Department of Pathology, Army Hospital (R&R), Delhi Cantt, Delhi, 110010 India
| | - Pankaj Vats
- 1Department of Radiation Oncology, Army Hospital (R&R), Delhi Cantt, Delhi, 110010 India
| | - N Chakravarty
- 1Department of Radiation Oncology, Army Hospital (R&R), Delhi Cantt, Delhi, 110010 India
| | - Tejas Pandya
- 1Department of Radiation Oncology, Army Hospital (R&R), Delhi Cantt, Delhi, 110010 India
| | - Nishant Lohia
- 1Department of Radiation Oncology, Army Hospital (R&R), Delhi Cantt, Delhi, 110010 India
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Sinha P, Tripathy DM, Radhakrishnan S, Verghese B, Sunita BS. Tuberculosis verrucosa cutis presenting with unilateral elephantiasis nostras verrucosa of the left lower limb: A rare entity. Int J Mycobacteriol 2019; 8:202-204. [PMID: 31210168 DOI: 10.4103/ijmy.ijmy_38_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Elephantiasis nostras verrucosa is used to describe lymphedema of the lower limbs caused by a nonfilarial etiology. Infective etiologies include bacterial and fungal infections along with chronic venous stasis, postirradiation, congestive heart failure, obesity, and malignancies, all causes leading to lymphatic obstruction and edema. We herein describe a case of a 70-year-old male who presented with diffuse nonpitting edema of the entire left lower limb with cobblestoning of the surface with a positive Kaposi-Stemmer sign and presence of a verrucous plaque over the left ankle. Histopathology of the verrucous plaque revealed it to be tuberculosis verrucosa cutis (TVC). We report this rare presentation of TVC as a cause of unilateral lymphedema.
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Affiliation(s)
- Preema Sinha
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
| | | | | | - Biju Verghese
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
| | - B S Sunita
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
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Sunita BS, Sen A, Suhag V. To evaluate immunoreactivity of cyclooxygenase-2 in cases of endometrial carcinoma and correlate it with expression of p53 and vascular endothelial growth factor. J Cancer Res Ther 2019; 14:1366-1372. [PMID: 30488858 DOI: 10.4103/0973-1482.202890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Context Increased levels of prostaglandins have been detected in cancers of several anatomic sites, including those of endometrium. Several studies have shown that cyclooxygenase-2 (COX-2) expression is aberrantly increased in various human epithelial cancers, and cellular up-regulation of COX-2 may be a common mechanism in epithelial carcinogenesis. Aims To examine the expressions of COX-2, p53 and vascular endothelial growth factor (VEGF) in endometrial cancer and their relationships with clinicopathologic characteristics. Setting and Design A retrospective observational study in a tertiary care center of academic and research potential. Subjects and Methods Sections from fifty cases of endometrial carcinoma were stained imunohistochemically with COX-2, p53, and VEGF. The expressions of COX-2, p53, and VEGF in endometrial cancer were examined. Results COX-2 was positive 19 cases (38%) of endometrial carcinoma. The COX-2 immunopositivity was 50%, 28%, and 41% in Grade 1, Grade 2, and Grade 3; and 27%, 46%, 67%, and 100% cases of Stage I, II, III, IV, respectively. p53 was positive in 24 cases (48%); 0%, 33%, and 67% in Grade 1, Grade 2, and Grade 3; and 27%, 77%, 83%, and 100% cases of Stage I, II, III, IV, respectively. VEGF was positive in 21 cases (42%); of which 0%, 33%, and 67% cases were in Grade 1, Grade 2, and Grade 3; and 17%, 77%, 83%, and 100% cases were in Stage I, II, III, IV, respectively. Conclusion The expression of COX-2 increase with stage of the endometrial tumor and with the expression of p53 and VEGF in the endometrial carcinomas. COX-2 inhibitors may have role in the prevention of endometrial carcinomas in high-risk cases and in preventing recurrences after treatment.
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Affiliation(s)
- B S Sunita
- Department of Pathology, Army Hospital (R & R), New Delhi, India
| | - Arijit Sen
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Virender Suhag
- Department of Radiation Oncology, Army Hospital (R & R), New Delhi, India
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Suhag V, Sunita BS, Vats P, Chakravarty N, Jain M, Vashisht RS. Profile of patients undergoing palliative radiotherapy: A single-institute study from a tertiary care oncology center. South Asian J Cancer 2018; 6:190-193. [PMID: 29404305 PMCID: PMC5763637 DOI: 10.4103/sajc.sajc_149_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Palliative radiotherapy (PRT) plays a significant role in the palliation of symptoms in patients with cancer and constitutes nearly 50% of the workload in different settings. Aims: The aim is to study patient-, disease-, and treatment-related characteristics in locoregionally advanced and metastatic malignancies meriting palliative management. Setting and Design: This was a retrospective observational study in a tertiary care government institute with academic and research potential. Methodology: The electronic medical records, medical documents, and radiotherapy (RT) treatment charts were retrieved and studied. Observations: A total of 460 patients were included in the study over 2 years, forming 30% of the total number of patients treated during the study period. Three hundred and ninety-six patients received PRT to the metastatic sites, while 64 patients received extremely hypofractionated PRT to the primary for symptomatic relief. Totally 442 patients showed good symptomatic response to PRT. One hundred and thirty-eight patients underwent re-irradiation. Lung was the most common primary site seen in 155 cases. The most common indication for PRT was palliation of pain from painful metastases as seen in 240 cases, and the next common indication was palliative whole-brain RT for brain metastases as seen in 159 cases. Conclusion: PRT forms an integral and important aspect of palliative care to the vast number of patients harboring metastatic disease that warrants some form of treatment for symptomatic relief. Short course of PRT in outdoor setting is a preferred mode of treatment to improve the quality of life of these distressed patients.
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Affiliation(s)
- Virender Suhag
- Department of Radiation Oncology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India
| | - B S Sunita
- Department of Pathology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India
| | - Pankaj Vats
- Department of Radiation Oncology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India
| | - Nilotpal Chakravarty
- Department of Radiation Oncology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India
| | - Mayuri Jain
- Department of Radiation Oncology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India
| | - Rekha S Vashisht
- Department of Radiation Oncology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India
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Suhag V, Sunita BS, Vats P, Sarin A, Singh AK, Jain M. Clinical Profile of Pediatric Oncology Patients Treated by External Beam Radiotherapy: An Institutional Experience. Indian J Med Paediatr Oncol 2017; 38:28-32. [PMID: 28469334 PMCID: PMC5398103 DOI: 10.4103/0971-5851.203497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction: Pediatric tumors are a heterogeneous group of malignant conditions requiring multimodal treatment, and management of such cases is at time challenging. We present the clinical profile of pediatric cancer patients who received radiation, either alone or as adjuvant to surgery and chemotherapy; in prophylactic, radical or palliative clinical setting. Aim: This study was envisaged to review our experience of pediatric oncology cases, their clinical and morphological profile, dosage schedule of radiotherapy, and the therapy induced complications. Settings and Design: This was a retrospective, observational study carried out in an apex tertiary care cancer institute of government set-up in a developing country. Materials and Methods: The treatment charts and clinical summary of patients who had received radiation over the last 5 years period were retrieved and perused. Various clinical and pathological parameters were studied and inferences drawn. Results: A total of 50 patients got radiation over 5 year study-period, including 37 male and 13 female patients. The commonest age group of presentation was 8-12 years followed by 13-16 years. The mean age of presentation was 9.3 years. The most common diagnosis was hematological malignancies followed by CNS tumors with 21 and 13 patients respectively. Overall the most common indication of RT was in adjuvant setting after surgery as the definitive management, where 24 patients were irradiated; and the next common indication was prophylactic cranial irradiation in 14 patients of childhood leukemias. 10 patients tolerated treatment with Grade 1 site-specific or systemic toxicities while 7 patients developed Grade 2 and more systemic toxicities. 9 patients received craniospinal irradiation, common indications being medulloblastoma and Atypical teratoma rhabdoid tumor (ATRT). 3 patients received concurrent chemotherapy with weekly Inj Vincristine. 17 patients required sedation or short general anaesthesia for radiation planning and execution. Conclusion: External beam Radiotherapy constitutes an important component of management of pediatric cancers. One should be judicious in Radiotherapy planning, execution and monitoring acute and delayed toxicities.
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Affiliation(s)
- Virender Suhag
- Department of Radiotherapy, Army Hospital RR, Delhi, India
| | - B S Sunita
- Department of Pathology, Army Hospital RR, Delhi, India
| | - Pankaj Vats
- Department of Radiotherapy, Army Hospital RR, Delhi, India
| | - Arti Sarin
- Department of Radiotherapy, Command Hospital (SC) Pune, Maharashtra, India
| | - A K Singh
- Department of Radiodiagnosis, Army Hospital RR, Delhi, India
| | - Mayuri Jain
- Department of Radiotherapy, Army Hospital RR, Delhi, India
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Suhag V, Sunita BS, Vats P, Sarin A, Singh AK, Jain M. Disease characteristics and treatment attributes of patients admitted to the oncology ward of a tertiary care government hospital. J Cancer Res Ther 2017; 13:44-50. [DOI: 10.4103/jcrt.jcrt_1283_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sen A, Sunita BS. CD44 positive/CD24 negative (stem cell like property) breast carcinoma cells as marker of tumor aggression. Med J Armed Forces India 2016; 73:29-35. [PMID: 28123242 DOI: 10.1016/j.mjafi.2016.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 02/22/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Cells with stem cell like properties in solid organ malignancies like breast and pancreas have been studied over the last decade and have been found to be associated with poor prognosis. Presence of CD44 positive and CD24 negative tumor cells in breast carcinoma (cells with 'stem cell' like property) as marker of aggressiveness and poor prognosis was checked for association with various markers of disease aggression like age at presentation, size of tumor, histological grade of tumor, triple negative status, level of micro-vessel density, and nodal status. METHODS Single and double staining immunohistochemistry protocol was used for CD24 and CD44 staining. The staining protocol was repeated with more contemporary techniques using fluorescent chromogen also. RESULTS 52 cases, all females who underwent modified radical mastectomy at a tertiary care hospital over a period of 3 years, were evaluated. No association was found between presence of stem cells and size of lesion, histological grade, triple negative status or micro-vessel density. However, significant association was found with respect to younger age of presentation (p value = 0.044). 20 out of 25 cases with nodal metastasis were positive for presence of stem cells (p value is 0.0003). Further, 18 of these 20 cases also had stem cells in the metastatic nodule. Fluorescent chromogens (FITC and Cyanine Red) revealed similar results. CONCLUSION Cases positive for stem cells showed earlier onset of disease and proneness to nodal metastasis.
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Affiliation(s)
- Arijit Sen
- Associate Professor, Dept of Pathology, Armed Forces Medical College, Pune 411040, India
| | - B S Sunita
- Classified Specialist (Pathology), Base Hospital, Delhi Cantt 110010, India
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Abstract
Altered bowels habits along with rectal mass in an elderly would point toward a rectal cancer. We report an unusual case of a post-menopausal lady who presented with these complaints. We had difficulties in establishing a pre-operative diagnosis. With a tentative diagnosis of a rectal cancer/gastrointestinal stromal tumor, she underwent a laparoscopic anterior resection. On histopathology, this turned out to be endometriosis. Bowel endometriosis is an uncommon occurrence. That it occurred in a post-menopausal lady was a very unusual finding. We discuss the case, its management, and the relevant literature.
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Affiliation(s)
- C. K. Jakhmola
- Department of GI Surgery, Surgical Division, Base Hospital, Delhi Cantonment, New Delhi, India
| | - Ameet Kumar
- Department of GI Surgery, Surgical Division, Base Hospital, Delhi Cantonment, New Delhi, India
- Address for Correspondence: Dr. Ameet Kumar, Department of GI Surgery, Surgical Division, Base Hospital, Delhi Cantonment - 110 010, New Delhi, India. E-mail:
| | - B. S. Sunita
- Department of Pathology, Base Hospital, Delhi Cantonment, New Delhi, India
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Abstract
Infertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the forefront the potential for fertility preservation in patients being treated for cancer. Many survivors will maintain their reproductive potential after the successful completion of treatment for cancer. However total body irradiation, radiation to the gonads, and certain high dose chemotherapy regimens can place women at risk for acute ovarian failure or premature menopause and men at risk for temporary or permanent azoospermia. Providing information about risk of infertility and possible interventions to maintain reproductive potential are critical for the adolescent and young adult population at the time of diagnosis. There are established means of preserving fertility before cancer treatment; specifically, sperm cryopreservation for men and in vitro fertilization and embryo cryopreservation for women. Several innovative techniques are being actively investigated, including oocyte and ovarian follicle cryopreservation, ovarian tissue transplantation, and in vitro follicle maturation, which may expand the number of fertility preservation choices for young cancer patients. Fertility preservation may also require some modification of cancer therapy; thus, patients’ wishes regarding future fertility and available fertility preservation alternatives should be discussed before initiation of therapy.
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Affiliation(s)
- Virender Suhag
- Department of Radiation Oncology, HOD Radiation Oncology, Army Hospital (Research and Referral), New Delhi, India
| | - B S Sunita
- Department of Pathology, Base Hospital, New Delhi, India
| | - Arti Sarin
- Department of Radiation Oncology, HOD Radiation Oncology, Army Hospital (Research and Referral), New Delhi, India
| | - A K Singh
- Department of Radiation Oncology, HOD Radiation Oncology, Army Hospital (Research and Referral), New Delhi, India
| | - S Dashottar
- Department of Radiation Oncology, HOD Radiation Oncology, Army Hospital (Research and Referral), New Delhi, India
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Bisht YS, Bhasin R, Manoj S, Sunita BS, Singhal E. Becker's nevus syndrome. Med J Armed Forces India 2015; 71:S89-91. [PMID: 26265883 DOI: 10.1016/j.mjafi.2013.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 04/22/2013] [Indexed: 11/19/2022] Open
Affiliation(s)
- Y S Bisht
- Senior Advisor (Dermatology), Base Hospital, Lucknow, India
| | - Rohit Bhasin
- Classified Specialist (Dermatology & Venereology), Base Hospital, Lucknow, India
| | - S Manoj
- Classified Specialist (Medicine & Neurology), Command Hospital (Central Command), Lucknow, India
| | - B S Sunita
- Graded Specialist (Pathology), Command Hospital (Central Command), Lucknow, India
| | - Esha Singhal
- Resident (Dermatology & Venereology), Base Hospital, Lucknow, India
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Sen D, Satija L, Kumar KS, Rastogi V, Sunita BS. Giant intra-articular extrasynovial osteochondroma of the Hoffa's fat pad. Med J Armed Forces India 2015; 71:S8-S11. [PMID: 26265880 DOI: 10.1016/j.mjafi.2012.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 11/09/2012] [Indexed: 11/19/2022] Open
Affiliation(s)
- Debraj Sen
- Graded Specialist (Radiodiagnosis), Command Hospital (CC), Lucknow, UP, India
| | - Lovleen Satija
- Consultant & Prof (Radiodiagnosis), Command Hospital (CC), Lucknow, UP, India
| | - K S Kumar
- Senior Advisort (Surg & Ortho), Base Hospital (CC), Lucknow, UP, India
| | - Vikas Rastogi
- Classified Specialist (Radiodiagnosis & Interventionist), Command Hospital (CC), Lucknow, UP, India
| | - B S Sunita
- Graded Specialist (Pathology), Command Hospital (CC), Lucknow, UP, India
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Chauhan A, Sharma A, Sunita BS. Cutaneous metastasis as primary presentation in unsuspected carcinoma esophagus: Report of two cases. J Cancer Res Ther 2015; 11:667. [DOI: 10.4103/0973-1482.143347] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Manocha S, Suhag V, Sunita BS, Hooda HS, Singh S. Comparison of sequential chemoradiation with radiation alone in the treatment of advanced head and neck cancers. Indian J Otolaryngol Head Neck Surg 2012; 58:57-60. [PMID: 23120238 DOI: 10.1007/bf02907742] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To compare locoregional control with alternating chemo radiation and radiation alone in patients with locally advanced head and neck carcinoma. STUDY DESIGN A prospective randomized study. SETTING Tertiary academic referral center. PATIENTS 50 patients of biopsy proven locally-advanced carcinoma of head and neck. INTERVENTION 25 patients were kept in Group I or study group (i.e. alternating chemo-radiation) and 25 patients in Group II or control group (i.e. radiation alone). In the study group, patients were given 3 cycles of chemotherapy (Cisplatin 20 mg/m([2]) and Inj. 5-FU 200mg/m([2]) from day 1-5 of each week) during weeks 1,5 and 9 alternated with radiation dose of 10Gy/week was given during weeks 2,3,4 and 6,7,8. In the control group, patients were given a total dose of 60Gy in 6 weeks. OUTCOME MEASURES The response rate at the primary site and nodal site was better in study group as compared to control group. RESULTS On comparing the response at the primary and nodal site together, 72% (18/25) patients of group I and 44% (11/25) patients of group II showed CR. PR was seen in 28% (7/25) and 36% (9/25) patients in group I and II respectively. No response was seen in 5/25 (20%) of patients in Group II. CONCLUSION Our study has revealed that alternating/ sequential chemoradiation is a promising and feasible approach for patients in advanced head and neck cancer.
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Affiliation(s)
- Sapna Manocha
- Department of Radiotherapy and Oncology, Government Medical College, Chandigarth, India
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Suhag V, Sunita BS, Sridhar PS, Rautray D, Singh HP, Kallur KG, Nagaraj KR. Carcinoma Buccal Mucosa with Metastasis to Left Adrenal. Med J Armed Forces India 2011; 67:80-2. [PMID: 27365770 DOI: 10.1016/s0377-1237(11)80027-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 07/19/2010] [Indexed: 11/19/2022] Open
Affiliation(s)
- Virender Suhag
- Graded Specialist (Radiotherapy), Command Hospital (AF), Bangalore-07
| | - B S Sunita
- Graded Specialist (Pathology), Command Hospital (AF), Bangalore-07
| | - P S Sridhar
- Consultant (Radiation Oncologist), Bangalore Institute of Oncology, Bangalore
| | - D Rautray
- Senior Advisor (Surgery & Oncosurgery), Command Hospital (AF), Bangalore-07
| | - H P Singh
- Senior Advisor (Medicine & Med Oncology), Command Hospital (CC), Lucknow
| | - K G Kallur
- Consultant (Nuclear Medicine), Bangalore Institute of Oncology, Bangalore
| | - K R Nagaraj
- Consultant (Radiology), Bangalore Institute of Oncology, Bangalore
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Affiliation(s)
- Alka Sehgal
- Department of Obstetrics & Gynaecology, Government Medical College and Hospital, Sector 32, Chandigarh, India
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